Bacterial pneumonia laboratory findings

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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. Other tests routinely done include electrolyte assessment, renal function tests, arterial blood gasses. pulse oximetry, gram staining and sputum samples. Blood cultures and PCR tests are sensitive tests that can provide a definitive diagnosis and aid in the selection of antibiotics.

Laboratory Findings

[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
  • A common practice in hospitalized patients

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
  • A common practice in hospitalized patients

Polymerase Chain Reaction

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

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.

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