Title: Laboratory testing for Spinal Epidural Abscess<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p> <span style="font-size:16px;"><strong>Laboratory testing for Spinal Epidural Abscess</strong></span></p> <p> <span style="font-size:14px;"><strong>CBC</strong></span></p> <p> <span style="font-size:14px;">The CBC is poorly sensitive/specific</span></p> <p> <span style="font-size:14px;">The WBC count may be nml or elevated</span></p> <p> <span style="font-size:14px;">Left shift and bandemia may or may not be present</span></p> <p> <span style="font-size:14px;"><strong>ESR and CRP </strong></span></p> <p> <span style="font-size:14px;">Sensitive but not specific</span></p> <p> <span style="font-size:14px;">Elevated in >80% with vertebral osteomyelitis.</span></p> <ul style="list-style-type:circle;"> <li> <span style="font-size:14px;">Sensitive for spinal infection, but not extremely specific.</span></li> </ul> <p> </p> <ul style="list-style-type:circle;"> <li> <span style="font-size:14px;"><strong>ESR</strong></span> <ul> <li> <span style="font-size:14px;">ESR was elevated in 94-100% of patients with SEA vs. only 33% of non-SEA patients</span></li> </ul> </li> <li> <span style="font-size:14px;"><strong>CRP</strong></span> <ul> <li> <span style="font-size:14px;">Less useful for acute diagnosis since CRP levels rise faster and return to baseline faster than ESR</span> <ul> <li> <span style="font-size:14px;">Elevated CRP seen in 87% of patients with SEA as well as in 50% of patients with spine pain not due to a SEA</span></li> </ul> </li> <li> <span style="font-size:14px;">Better used as a marker of response to treatment.</span></li> </ul> </li> </ul> <p> </p> <p> </p> <p> </p> <fieldset><legend>References</legend>
<p> Reihsaus E, et al. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 2000.</p> </fieldset>