Lipoid pneumonia laboratory findings: Difference between revisions
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{{lipoid pneumonia}} | {{lipoid pneumonia}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{RG}} | ||
==Overview== | ==Overview== | ||
Different laboratory tests might be used in patients with aspiration pneumonia. [[Sputum]] analysis including lipid laden [[macrophage]], [[Gram staining|gram stain]] and culture must be done in patients with [[cough]]. [[Arterial blood gas|ABG]] may show acute [[hypoxemia]] and decreased mixed venous [[oxygen saturation]]. [[Complete blood count|CBC]] shows [[leukocytosis]] with left shift or [[leukopenia]], [[anemia]], or [[thrombocytopenia]]. | |||
==Laboratory Tests== | |||
===Routine Tests=== | |||
Findings in routine blood tests are based on the severity of the disease and the cause, they can include the following:<ref name="SolomonWunderink2014">{{cite journal|last1=Solomon|first1=Caren G.|last2=Wunderink|first2=Richard G.|last3=Waterer|first3=Grant W.|title=Community-Acquired Pneumonia|journal=New England Journal of Medicine|volume=370|issue=6|year=2014|pages=543–551|issn=0028-4793|doi=10.1056/NEJMcp1214869}}</ref> | |||
*[[Complete blood count|CBC]] shows: | |||
**[[Leukocytosis]] with left shift (in cases of bacterial pneumonia) | |||
**[[Leukopenia]] (in cases of atypical pneumonia) | |||
**[[Eosinophilia]] (in cases of [[eosinophilic pneumonia]]) | |||
**[[Anemia]] | |||
**[[Thrombocytopenia]] | |||
*[[Hyponatremia]] | |||
*Elevated [[BUN]] | |||
*[[ABG]] may show: | |||
**Acute [[hypoxemia]] | |||
**Normal to low partial pressure of [[carbon dioxide]] | |||
**Decreased mixed venous oxygen saturation if a patient is in [[Sepsis|septic shock]] | |||
**Decreased [[Bicarbonate|HCO<sub>3</sub>]] | |||
**High [[Lactic acidosis|lactate level]] if a patient is in [[Sepsis|septic shock]] | |||
===Sputum Gram Stain and Culture=== | |||
*[[Sputum]] samples should be obtained in all patients with productive [[cough]].<ref name="ParameswaranAnvari2000">{{cite journal|last1=Parameswaran|first1=K.|last2=Anvari|first2=M.|last3=Efthimiadis|first3=A.|last4=Kamada|first4=D.|last5=Hargreave|first5=F.e|last6=Allen|first6=C.j|title=Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration|journal=European Respiratory Journal|volume=16|issue=6|year=2000|pages=1119–1122|issn=0903-1936|doi=10.1034/j.1399-3003.2000.16f17.x}}</ref><ref name="BetancourtMartinez-Jimenez2010">{{cite journal|last1=Betancourt|first1=Sonia L.|last2=Martinez-Jimenez|first2=Santiago|last3=Rossi|first3=Santiago E.|last4=Truong|first4=Mylene T.|last5=Carrillo|first5=Jorge|last6=Erasmus|first6=Jeremy J.|title=Lipoid Pneumonia: Spectrum of Clinical and Radiologic Manifestations|journal=American Journal of Roentgenology|volume=194|issue=1|year=2010|pages=103–109|issn=0361-803X|doi=10.2214/AJR.09.3040}}</ref> | |||
*A [[sputum]] sample is easy to obtain, however, many patients do not produce any [[sputum]] and repeated attempts may be required to obtain a representative sample. | |||
*[[Sputum]] test however has questionable reliability and lipid-laden [[macrophages]] have been demonstrated in the absence of [[lipoid pneumonia]]. | |||
[ | *[[Gram staining|Gram stain]] and culture should be performed to assess the causative agent and guide the therapy. | ||
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*[ | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Medicine]] | |||
[[Category:Pulmonology]] | |||
[[Category: | [[Category:Up-To-Date]] | ||
[[Category:Emergency medicine]] | |||
Latest revision as of 22:30, 29 July 2020
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Lipoid pneumonia Microchapters |
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Lipoid pneumonia laboratory findings On the Web |
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Risk calculators and risk factors for Lipoid pneumonia laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]
Overview
Different laboratory tests might be used in patients with aspiration pneumonia. Sputum analysis including lipid laden macrophage, gram stain and culture must be done in patients with cough. ABG may show acute hypoxemia and decreased mixed venous oxygen saturation. CBC shows leukocytosis with left shift or leukopenia, anemia, or thrombocytopenia.
Laboratory Tests
Routine Tests
Findings in routine blood tests are based on the severity of the disease and the cause, they can include the following:[1]
- CBC shows:
- Leukocytosis with left shift (in cases of bacterial pneumonia)
- Leukopenia (in cases of atypical pneumonia)
- Eosinophilia (in cases of eosinophilic pneumonia)
- Anemia
- Thrombocytopenia
- Hyponatremia
- Elevated BUN
- ABG may show:
- Acute hypoxemia
- Normal to low partial pressure of carbon dioxide
- Decreased mixed venous oxygen saturation if a patient is in septic shock
- Decreased HCO3
- High lactate level if a patient is in septic shock
Sputum Gram Stain and Culture
- Sputum samples should be obtained in all patients with productive cough.[2][3]
- A sputum sample is easy to obtain, however, many patients do not produce any sputum and repeated attempts may be required to obtain a representative sample.
- Sputum test however has questionable reliability and lipid-laden macrophages have been demonstrated in the absence of lipoid pneumonia.
- Gram stain and culture should be performed to assess the causative agent and guide the therapy.
References
- ↑ Solomon, Caren G.; Wunderink, Richard G.; Waterer, Grant W. (2014). "Community-Acquired Pneumonia". New England Journal of Medicine. 370 (6): 543–551. doi:10.1056/NEJMcp1214869. ISSN 0028-4793.
- ↑ Parameswaran, K.; Anvari, M.; Efthimiadis, A.; Kamada, D.; Hargreave, F.e; Allen, C.j (2000). "Lipid-laden macrophages in induced sputum are a marker of oropharyngeal reflux and possible gastric aspiration". European Respiratory Journal. 16 (6): 1119–1122. doi:10.1034/j.1399-3003.2000.16f17.x. ISSN 0903-1936.
- ↑ Betancourt, Sonia L.; Martinez-Jimenez, Santiago; Rossi, Santiago E.; Truong, Mylene T.; Carrillo, Jorge; Erasmus, Jeremy J. (2010). "Lipoid Pneumonia: Spectrum of Clinical and Radiologic Manifestations". American Journal of Roentgenology. 194 (1): 103–109. doi:10.2214/AJR.09.3040. ISSN 0361-803X.