So, obviously, imaging of the brain is needed
and what we’re looking for is computed tomography,
which will show you a hypodense center
with surrounding ring enhancement.
And the MRI is actually more sensitive
than the CT scan, especially for toxoplasmosis.
And if we have some spinal fluid,
and sometimes it's not safe to get spinal fluid
because of increased intracranial pressure,
we would do PCR, looking for various causes.
if we can safely aspirate the abscess, we will do so.
And if the Gram stain shows you mixed flora,
we would design therapy according.
So, we would expect aerobic
and anaerobic cultures to be done.
We would expect an acid-fast stain to be done.
We would do fungal stains.
In other words, a patient shouldn't have to undergo
an invasive procedure
without essentially getting everything known to man
done on the specimen.
If they have a suspicion of Toxo,
we can do the serology and a CSF PCR.