TEST BANK FOR Interpreting Findings and Formulating Differential Diagnoses

Signs and Symptoms If the condition represents an extension of a pre- existing problem, the history will be consistent with that condition and with the symptoms specifically related to the abscess. The history usually includes a gradual onset of symptoms that progress as the inflammatory process increases. These symptoms include head-ache, nausea (with or without vomiting), lethargy, and fever. Over time, if the lesion expands, the symptoms progress to include seizures, lethargy, hemiparesis, and altered mental status. If left untreated, the patient can rapidly decline to seizures and coma. Diagnostic Studies Diagnostic tests for patients suspected of brain abscess include CBC (may be normal in the early stage or in older patients), ESR, C-reactive protein, and blood cultures (may be negative). An MRI of the brain with and without contrast will show enhancing lesions, and this is the test of choice for localization. Magnetic resonance spectroscopy may also help in determining the activity of the abscess. Lumbar puncture is not recommended in the initial work-up for intracranial abscess.