C-reactive protein monitoring in the management of intracranial abscess.
C-reactive protein (CRP) content was measured serially in 12 patients with intracranial abscess. All patients had undergone surgery and were treated with antimicrobial therapy. The CRP content ultimately returned to normal in 11 patients and this correlated with good recovery in all. Death in one patient with a high CRP level was due to pulmonary embolism. In one case, the CRP level remained elevated because of an inadequately treated chronic ear infectionl; a second peak correlated with reinfection. In two patients, a persistently high CRP level postoperatively coincided with a re-formation of the abscess. One patient had an unexplained normal CRP level two days after his abscess was excised. A transient rise in the CRP value during an uneventful decrease to normal was due to deep venous thrombosis in one case. CRP levels in patients with intracranial abscess is useful for monitoring the effectiveness of treament but must be used in combination with the clinical response and computed tomographic scans. These can provide guidelines for terminating antimicrobial therapy.
Jamjoom
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Division of Neurosurgery, College of Medicine, King Khalid University Hospital, Riyadh and Frenchay Hospital, Bristol, England.
Brown
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Griffith
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H