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, M.B.B.S

Overview

Patients infected with bacterial pneumonia present with a high leukocyte count as well as elevated inflammatory biomarkers, including ESR and C-RP. Red blood cell and platelet count can also be affected presenting as anemia and thrombocytopenia. Arterial blood gasses will often show changes in pH leading to a respiratory acidosis. Other tests routinely done include electrolyte assessment, renal function tests, 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

CBC[1]

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

Electrolytes[1]

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

Inflammatory biomarkers[1]

RFTs[1]

Arterial Blood Gas[1]

Pulse oximetry[1]

  • < 92% indicates severe hypoxia

Blood Culture[1]

  • 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[1]

Sputum samples[1]

  • 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. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 "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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