title: High extracellular levels of potassium and trace metals in human brain abscess.
abstract: Brain abscesses frequently cause symptoms such as seizures, delirium, paresis and sensory deficits that could reflect brain edema, increased intracranial pressure, or tissue destruction. However, it is also possible that pus constituents could disturb neuronal function in the surrounding brain tissue. In pus from 16 human brain abscesses, extracellular potassium ([K(+)]o) was 10.6 ± 4.8 mmol/L (mean ± SD; maximum value 22.0 mmol/L). In cerebrospinal fluid (CSF), [K(+)]o was 2.7 ± 0.6 mmol/L (N = 14; difference from pus p < 0.001), which is similar to previous control values for [K(+)]o in CSF and brain parenchyma. Zinc and iron were >40-fold higher in pus than in CSF; calcium, copper, manganese, and chromium were also higher, whereas sodium and magnesium were similar. Pus from 10 extracerebral abscesses (empyemas) also had higher [K(+)]o, zinc, iron, calcium, copper, manganese, and chromium than did CSF. Brain abscess [K(+)]o was significantly higher than serum potassium (3.8 ± 0.5 mmol/L; p = 0.0001), indicating that the elevated abscess [K(+)]o originated from damaged cells (e.g. brain cells and leukocytes), not from serum. High [K(+)]o could depolarize neurons, high levels of zinc could inhibit glutamate and GABA receptors, and high levels of iron and copper could cause oxidative damage, all of which could contribute to neuronal dysfunction in brain abscess patients.
authors: Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
authors: Daniel
authors: D
authors: Dahlberg
authors: Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.
authors: Jugoslav
authors: J
authors: Ivanovic
authors: Norwegian Defence Research Establishment (FFI), Kjeller, Norway.
authors: Espen
authors: E
authors: Mariussen
authors: Norwegian Defence Research Establishment (FFI), Kjeller, Norway; Department of Neurology, Oslo University Hospital, Oslo, Norway. Electronic address: bjornar.hassel@ffi.no.
authors: Bjørnar
authors: B
authors: Hassel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids / Q000737:chemistry; D001922:Brain Abscess / Q000150:complications / Q000378:metabolism*; D001923:Brain Chemistry; D002413:Cations, Divalent / Q000032:analysis; D002414:Cations, Monovalent / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D045604:Extracellular Fluid / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D009069:Movement Disorders / Q000209:etiology; D009928:Organ Specificity; D011188:Potassium / Q000032:analysis*; D012678:Sensation Disorders / Q000209:etiology; D013492:Suppuration / Q000378:metabolism; D014131:Trace Elements / Q000032:analysis*; D055815:Young Adult
chemical_list: D002413:Cations, Divalent; D002414:Cations, Monovalent; D014131:Trace Elements; D011188:Potassium
keywords: Brain abscess; Cerebrospinal fluid; Epilepsy; Potassium; Serum; Zinc