Empyema laboratory findings: Difference between revisions
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A positive bacteria culture from pleural fluid is not needed to make diagnosis of empyema.<ref name="pmid3548615">{{cite journal| author=Mavroudis C, Ganzel BL, Cox SK, Polk HC| title=Experimental aerobic-anaerobic thoracic empyema in the guinea pig. | journal=Ann Thorac Surg | year= 1987 | volume= 43 | issue= 3 | pages= 298-302 | pmid=3548615 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3548615 }} </ref><ref name="pmid27527890">{{cite journal| author=Perez VP, Caierão J, Fischer GB, Dias CA, d'Azevedo PA| title=Pleural effusion with negative culture: a challenge for pneumococcal diagnosis in children. | journal=Diagn Microbiol Infect Dis | year= 2016 | volume= 86 | issue= 2 | pages= 200-4 | pmid=27527890 | doi=10.1016/j.diagmicrobio.2016.07.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27527890 }} </ref> | A positive bacteria culture from pleural fluid is not needed to make diagnosis of empyema.<ref name="pmid3548615">{{cite journal| author=Mavroudis C, Ganzel BL, Cox SK, Polk HC| title=Experimental aerobic-anaerobic thoracic empyema in the guinea pig. | journal=Ann Thorac Surg | year= 1987 | volume= 43 | issue= 3 | pages= 298-302 | pmid=3548615 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3548615 }} </ref><ref name="pmid27527890">{{cite journal| author=Perez VP, Caierão J, Fischer GB, Dias CA, d'Azevedo PA| title=Pleural effusion with negative culture: a challenge for pneumococcal diagnosis in children. | journal=Diagn Microbiol Infect Dis | year= 2016 | volume= 86 | issue= 2 | pages= 200-4 | pmid=27527890 | doi=10.1016/j.diagmicrobio.2016.07.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27527890 }} </ref> | ||
The COMPLES score has been developed to differentiate between tuberculous effusions with low pleural pH or glucose and complicated parapneumonic effusions. The components are: | |||
pleural fluid adenosine deaminase (ADA) (<46 IU/L [0 points] | |||
the percentage of mononuclear cells (MNC %), ≥100 IU/L [6 points]), 46-100 IU/L [4 points], MNC % (<10 % [0 points], 10-50 [3 points], >50 [8 points]) | |||
pH, pH (<7.07 [0 points], 7.07-7.20 [3 points], >7.20 [5 points]), | |||
age.age (≥30 [0 points], <30 years [3 points]) | |||
A score of 12 or more points is highly sensitivity and specificity for complicated tuberculous pleural effusion.<ref name="pmid27401009">{{cite journal| author=Corral-Gudino L, García-Zamalloa A, Prada-González C, Bielsa S, Alexis D, Taboada-Gómez J et al.| title=Development and Validation of the COMPLES Score for Differentiating Between Tuberculous Effusions with Low Pleural pH or Glucose and Complicated Parapneumonic Effusions. | journal=Lung | year= 2016 | volume= 194 | issue= 5 | pages= 847-54 | pmid=27401009 | doi=10.1007/s00408-016-9923-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27401009 }} </ref> | |||
==References== | ==References== | ||
Revision as of 22:44, 6 January 2017
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Empyema Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
Diagnosis is confirmed by thoracentesis; frank pus may be aspirated from the pleural space. The pleural fluid typically has a low pH (<7.20), low glucose (<60 mg/dL), and contains infectious organisms. Therefore, the diagnosis relies on the presence of pus or organisms on gram stain.
A positive bacteria culture from pleural fluid is not needed to make diagnosis of empyema.[1][2]
The COMPLES score has been developed to differentiate between tuberculous effusions with low pleural pH or glucose and complicated parapneumonic effusions. The components are:
pleural fluid adenosine deaminase (ADA) (<46 IU/L [0 points] the percentage of mononuclear cells (MNC %), ≥100 IU/L [6 points]), 46-100 IU/L [4 points], MNC % (<10 % [0 points], 10-50 [3 points], >50 [8 points]) pH, pH (<7.07 [0 points], 7.07-7.20 [3 points], >7.20 [5 points]), age.age (≥30 [0 points], <30 years [3 points]) A score of 12 or more points is highly sensitivity and specificity for complicated tuberculous pleural effusion.[3]
References
- ↑ Mavroudis C, Ganzel BL, Cox SK, Polk HC (1987). "Experimental aerobic-anaerobic thoracic empyema in the guinea pig". Ann Thorac Surg. 43 (3): 298–302. PMID 3548615.
- ↑ Perez VP, Caierão J, Fischer GB, Dias CA, d'Azevedo PA (2016). "Pleural effusion with negative culture: a challenge for pneumococcal diagnosis in children". Diagn Microbiol Infect Dis. 86 (2): 200–4. doi:10.1016/j.diagmicrobio.2016.07.022. PMID 27527890.
- ↑ Corral-Gudino L, García-Zamalloa A, Prada-González C, Bielsa S, Alexis D, Taboada-Gómez J; et al. (2016). "Development and Validation of the COMPLES Score for Differentiating Between Tuberculous Effusions with Low Pleural pH or Glucose and Complicated Parapneumonic Effusions". Lung. 194 (5): 847–54. doi:10.1007/s00408-016-9923-y. PMID 27401009.