Bacterial pneumonia laboratory findings: Difference between revisions

Jump to navigation Jump to search
Line 4: Line 4:


==Overview==
==Overview==
Patients infected with bacterial pneumonia present with a high leukocyte count as well as elevated inflammatory biomarkers. Blood cultures can help with a definitive diagnosis and aid in the selection of antibiotics.
Patients infected with bacterial pneumonia present with a high leukocyte count as well as elevated inflammatory biomarkers. Blood cultures and PCR tests can help with a definitive diagnosis and aid in the selection of antibiotics.


==Routine Lab Tests==
==Routine Lab Tests==
Line 11: Line 11:
===CBC===
===CBC===


#RBC: Anemia
#RBC: [[Anemia]]
#WBC: significant leukocytosis (with left shift), leukopenia may present in cases of atypical pneumonia
#WBC: Significant [[leukocytosis]] (with left shift), leukopenia may present in cases of atypical pneumonia
#Platelets: Thrombocytopenia
#Platelets: [[Thrombocytopenia]]


===Electrolytes===
===Electrolytes===


*Hyponatremia (in cases of ''Legionella'')
*Electrolytes are particularly helpful but hyponatremia may be present in cases of ''[[Legionella]]''


===Inflammatory biomarkers===
===Inflammatory biomarkers===


*ESR: elevated
*[[Erythrocyte sedimentation rate]]: Elevated
*C-reactive protein: elevated
*[[C-reactive protein (CRP)|C-reactive protein]]: Elevated


===RFTs===
===RFTs===
Line 31: Line 31:


*Hypoxia
*Hypoxia
*Respiratory acidosis
*[[Respiratory acidosis]] (pH <7.2, bicarbonate <22 mEq/L)


===Pulse oximetry===
===Pulse oximetry===
Line 39: Line 39:
===Blood Culture===
===Blood Culture===


*samples should be taken before administering antibiotics
*Blood culture samples are necessary in diagnosing the bacterial agent responsible. Samples should be taken before administering antibiotics


==Other Lab Tests==
==Other Lab Tests==
Line 45: Line 45:
===Gram staining===
===Gram staining===


*may assist in determining the underlying bacteria
*Gram staining can identify if an organism is gram positive, gram negative, or does not have a cell wall as in the case of ''[[Mycoplasma]]''


===Sputum samples===
===Sputum samples===


*should be obtained when patient presents with a productive cough
*Sputum samples should be obtained when patient presents with a productive cough


===Polymerase Chain Reaction===
===Polymerase Chain Reaction===


*provides sensitive and rapid results<ref name="pmid25225517">{{cite journal| author=Aydemir O, Aydemir Y, Ozdemir M| title=The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections. | journal=Pak J Med Sci | year= 2014 | volume= 30 | issue= 5 | pages= 1011-6 | pmid=25225517 | doi=10.12669/pjms.305.5098 | pmc=4163223 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25225517  }} </ref>
*PCR results are very rapid and sensitive for detection of bacteria<ref name="pmid25225517">{{cite journal| author=Aydemir O, Aydemir Y, Ozdemir M| title=The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections. | journal=Pak J Med Sci | year= 2014 | volume= 30 | issue= 5 | pages= 1011-6 | pmid=25225517 | doi=10.12669/pjms.305.5098 | pmc=4163223 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25225517  }} </ref>


===Urine Antigen===
===Urine Antigen===


*used to detect 'Legionella''<ref name="pmid24856525">{{cite journal| author=Couturier MR, Graf EH, Griffin AT| title=Urine antigen tests for the diagnosis of respiratory infections: legionellosis, histoplasmosis, pneumococcal pneumonia. | journal=Clin Lab Med | year= 2014 | volume= 34 | issue= 2 | pages= 219-36 | pmid=24856525 | doi=10.1016/j.cll.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24856525  }} </ref>''
*Urine antigen samples are not often used, but may assist in the diagnosis of ''[[Legionella]]<ref name="pmid24856525">{{cite journal| author=Couturier MR, Graf EH, Griffin AT| title=Urine antigen tests for the diagnosis of respiratory infections: legionellosis, histoplasmosis, pneumococcal pneumonia. | journal=Clin Lab Med | year= 2014 | volume= 34 | issue= 2 | pages= 219-36 | pmid=24856525 | doi=10.1016/j.cll.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24856525  }} </ref>''


===Bronchoalveolar Lavage===
===Bronchoalveolar Lavage===


*Especially helpful in determining the presence of bacterial pneumonia in non-immunocompromised and mechanically ventilated patients<ref name="pmid8605896">{{cite journal| author=Sanchez Nieto JM, Carillo Alcaraz A| title=The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia. | journal=Eur J Clin Microbiol Infect Dis | year= 1995 | volume= 14 | issue= 10 | pages= 839-50 | pmid=8605896 | doi=10.1007/BF01691489 | pmc=7102128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8605896  }} </ref>
*BAL is especially helpful in determining the presence of bacterial pneumonia in non-immunocompromised and mechanically ventilated patients<ref name="pmid8605896">{{cite journal| author=Sanchez Nieto JM, Carillo Alcaraz A| title=The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia. | journal=Eur J Clin Microbiol Infect Dis | year= 1995 | volume= 14 | issue= 10 | pages= 839-50 | pmid=8605896 | doi=10.1007/BF01691489 | pmc=7102128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8605896  }} </ref>


==References==
==References==

Revision as of 10:58, 8 January 2022

Pneumonia Main Page

Bacterial pneumonia Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Bacterial pneumonia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Bacterial pneumonia laboratory findings On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Bacterial pneumonia laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Bacterial pneumonia laboratory findings

CDC onBacterial pneumonia laboratory findings

Bacterial pneumonia laboratory findings in the news

Blogs on Bacterial pneumonia laboratory findings

to Hospitals Treating Bacterial pneumonia

Risk calculators and risk factors for Bacterial pneumonia laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz

Overview

Patients infected with bacterial pneumonia present with a high leukocyte count as well as elevated inflammatory biomarkers. Blood cultures and PCR tests can help with a definitive diagnosis and aid in the selection of antibiotics.

Routine Lab Tests

[1]

CBC

  1. RBC: Anemia
  2. WBC: Significant leukocytosis (with left shift), leukopenia may present in cases of atypical pneumonia
  3. Platelets: Thrombocytopenia

Electrolytes

  • Electrolytes are particularly helpful but hyponatremia may be present in cases of Legionella

Inflammatory biomarkers

RFTs

  • BUN: elevated

Arterial Blood Gas

Pulse oximetry

  • < 92% indicates severe hypoxia

Blood Culture

  • Blood culture samples are necessary in diagnosing the bacterial agent responsible. Samples should be taken before administering antibiotics

Other Lab Tests

Gram staining

  • Gram staining can identify if an organism is gram positive, gram negative, or does not have a cell wall as in the case of Mycoplasma

Sputum samples

  • Sputum samples should be obtained when patient presents with a productive cough

Polymerase Chain Reaction

  • PCR results are very rapid and sensitive for detection of bacteria[2]

Urine Antigen

  • Urine antigen samples are not often used, but may assist in the diagnosis of Legionella[3]

Bronchoalveolar Lavage

  • BAL is especially helpful in determining the presence of bacterial pneumonia in non-immunocompromised and mechanically ventilated patients[4]

References

  1. "StatPearls". 2021. PMID 30020693.
  2. Aydemir O, Aydemir Y, Ozdemir M (2014). "The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections". Pak J Med Sci. 30 (5): 1011–6. doi:10.12669/pjms.305.5098. PMC 4163223. PMID 25225517.
  3. Couturier MR, Graf EH, Griffin AT (2014). "Urine antigen tests for the diagnosis of respiratory infections: legionellosis, histoplasmosis, pneumococcal pneumonia". Clin Lab Med. 34 (2): 219–36. doi:10.1016/j.cll.2014.02.002. PMID 24856525.
  4. Sanchez Nieto JM, Carillo Alcaraz A (1995). "The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia". Eur J Clin Microbiol Infect Dis. 14 (10): 839–50. doi:10.1007/BF01691489. PMC 7102128 Check |pmc= value (help). PMID 8605896.

Template:WH Template:WS