Bacterial pneumonia laboratory findings: Difference between revisions
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{{Bacterial pneumonia}} | {{Bacterial pneumonia}} | ||
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz]]<br /> | '''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]]<br /> | ||
==Overview== | ==Overview== | ||
Patients infected with [[bacterial pneumonia]] present with a high [[leukocyte]] count as well as elevated inflammatory [[biomarkers]] | Patients infected with [[bacterial pneumonia]] present with a high [[leukocyte]] count as well as elevated inflammatory [[biomarkers]], including [[Erythrocyte sedimentation rate|ESR]] and [[C reactive protein|C-RP]]. [[Red blood cell]] and [[platelet]] count can also be affected presenting as [[anemia]] and [[thrombocytopenia]]. [[ABG|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 culture|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== | ==Laboratory Findings== | ||
<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=30020693 | doi= | pmc= | url= }} </ref> | '''CBC'''<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=30020693 | doi= | pmc= | url= }} </ref> | ||
#[[RBC]]: [[Anemia]] | #[[RBC]]: [[Anemia]] | ||
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#[[Platelets]]: [[Thrombocytopenia]] | #[[Platelets]]: [[Thrombocytopenia]] | ||
'''[[Electrolyte|Electrolytes]]''' | '''[[Electrolyte|Electrolytes]]<ref name="pmid30020693" />''' | ||
*Electrolytes are particularly helpful but hyponatremia may be present in cases of ''[[Legionella]]'' | *Electrolytes are particularly helpful but hyponatremia may be present in cases of ''[[Legionella]]'' | ||
'''Inflammatory [[biomarkers]]''' | '''Inflammatory [[biomarkers]]<ref name="pmid30020693" />''' | ||
*[[Erythrocyte sedimentation rate]]: Elevated | *[[Erythrocyte sedimentation rate]]: Elevated | ||
*[[C-reactive protein (CRP)|C-reactive protein]]: Elevated (> 100 mg/L) | *[[C-reactive protein (CRP)|C-reactive protein]]: Elevated (> 100 mg/L) | ||
'''[[Renal function tests|RFTs]]''' | '''[[Renal function tests|RFTs]]<ref name="pmid30020693" />''' | ||
*[[BUN]]: elevated | *[[BUN]]: elevated | ||
'''[[ABG|Arterial Blood Gas]]''' | '''[[ABG|Arterial Blood Gas]]<ref name="pmid30020693" />''' | ||
*[[Hypoxia]] | *[[Hypoxia]] | ||
*[[Respiratory acidosis]] (pH <7.2, bicarbonate <22 mEq/L) | *[[Respiratory acidosis]] (pH <7.2, bicarbonate <22 mEq/L) | ||
'''[[Pulse oximetry]]''' | '''[[Pulse oximetry]]<ref name="pmid30020693" />''' | ||
*< 92% indicates severe hypoxia | *< 92% indicates severe hypoxia | ||
'''Blood Culture''' | '''Blood Culture<ref name="pmid30020693" />''' | ||
*Blood culture samples are necessary in diagnosing the bacterial agent responsible. 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]] | ||
*A common practice in hospitalized patients | *A common practice in hospitalized patients | ||
'''[[Gram staining]]''' | '''[[Gram staining]]<ref name="pmid30020693" />''' | ||
*Gram staining can identify if an organism is [[Gram positive bacteria|gram positive]], [[Gram-negative bacteria|gram negative]], or does not have a cell wall as in the case of ''[[Mycoplasma]]'' | *Gram staining can identify if an organism is [[Gram positive bacteria|gram positive]], [[Gram-negative bacteria|gram negative]], or does not have a cell wall as in the case of ''[[Mycoplasma]]'' | ||
'''[[Sputum culture|Sputum]] samples''' | '''[[Sputum culture|Sputum]] samples<ref name="pmid30020693" />''' | ||
*Sputum samples should be obtained when patient presents with a [[productive cough]] | *Sputum samples should be obtained when patient presents with a [[productive cough]] | ||
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[[Category:Pneumonia|Pneumonia]] | [[Category:Pneumonia|Pneumonia]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category: | [[Category:Up-to-date]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 00:53, 7 August 2022
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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]
- RBC: Anemia
- WBC: Significant leukocytosis (with left shift), leukopenia may present in cases of atypical pneumonia
- Platelets: Thrombocytopenia
- Electrolytes are particularly helpful but hyponatremia may be present in cases of Legionella
Inflammatory biomarkers[1]
- Erythrocyte sedimentation rate: Elevated
- C-reactive protein: Elevated (> 100 mg/L)
- BUN: elevated
- Hypoxia
- Respiratory acidosis (pH <7.2, bicarbonate <22 mEq/L)
- < 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 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 should be obtained when patient presents with a productive cough
- A common practice in hospitalized patients
- PCR results are very rapid and sensitive for detection of bacteria[2]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 "StatPearls". 2021. PMID 30020693.
- ↑ 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.