Bacterial pneumonia laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Patients infected with bacterial pneumonia present with a high leukocyte count as well as elevated inflammatory biomarkers. Blood cultures can help with a definitive diagnosis and aid in the selection of antibiotics. | Patients infected with bacterial pneumonia present with a high leukocyte count as well as elevated inflammatory biomarkers. Blood cultures and PCR tests can help with a definitive diagnosis and aid in the selection of antibiotics. | ||
==Routine Lab Tests== | ==Routine Lab Tests== | ||
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===CBC=== | ===CBC=== | ||
#RBC: Anemia | #RBC: [[Anemia]] | ||
#WBC: | #WBC: Significant [[leukocytosis]] (with left shift), leukopenia may present in cases of atypical pneumonia | ||
#Platelets: Thrombocytopenia | #Platelets: [[Thrombocytopenia]] | ||
===Electrolytes=== | ===Electrolytes=== | ||
* | *Electrolytes are particularly helpful but hyponatremia may be present in cases of ''[[Legionella]]'' | ||
===Inflammatory biomarkers=== | ===Inflammatory biomarkers=== | ||
* | *[[Erythrocyte sedimentation rate]]: Elevated | ||
*C-reactive protein: | *[[C-reactive protein (CRP)|C-reactive protein]]: Elevated | ||
===RFTs=== | ===RFTs=== | ||
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*Hypoxia | *Hypoxia | ||
*Respiratory acidosis | *[[Respiratory acidosis]] (pH <7.2, bicarbonate <22 mEq/L) | ||
===Pulse oximetry=== | ===Pulse oximetry=== | ||
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===Blood Culture=== | ===Blood Culture=== | ||
*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 | ||
==Other Lab Tests== | ==Other Lab Tests== | ||
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===Gram staining=== | ===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 | *Sputum samples should be obtained when patient presents with a productive cough | ||
===Polymerase Chain Reaction=== | ===Polymerase Chain Reaction=== | ||
* | *PCR results are very rapid and sensitive for detection of bacteria<ref name="pmid25225517">{{cite journal| author=Aydemir O, Aydemir Y, Ozdemir M| title=The role of multiplex PCR test in identification of bacterial pathogens in lower respiratory tract infections. | journal=Pak J Med Sci | year= 2014 | volume= 30 | issue= 5 | pages= 1011-6 | pmid=25225517 | doi=10.12669/pjms.305.5098 | pmc=4163223 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25225517 }} </ref> | ||
===Urine Antigen=== | ===Urine Antigen=== | ||
*used | *Urine antigen samples are not often used, but may assist in the diagnosis of ''[[Legionella]]<ref name="pmid24856525">{{cite journal| author=Couturier MR, Graf EH, Griffin AT| title=Urine antigen tests for the diagnosis of respiratory infections: legionellosis, histoplasmosis, pneumococcal pneumonia. | journal=Clin Lab Med | year= 2014 | volume= 34 | issue= 2 | pages= 219-36 | pmid=24856525 | doi=10.1016/j.cll.2014.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24856525 }} </ref>'' | ||
===Bronchoalveolar Lavage=== | ===Bronchoalveolar Lavage=== | ||
* | *BAL is especially helpful in determining the presence of bacterial pneumonia in non-immunocompromised and mechanically ventilated patients<ref name="pmid8605896">{{cite journal| author=Sanchez Nieto JM, Carillo Alcaraz A| title=The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia. | journal=Eur J Clin Microbiol Infect Dis | year= 1995 | volume= 14 | issue= 10 | pages= 839-50 | pmid=8605896 | doi=10.1007/BF01691489 | pmc=7102128 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8605896 }} </ref> | ||
==References== | ==References== | ||
Revision as of 10:58, 8 January 2022
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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. Blood cultures and PCR tests can help with a definitive diagnosis and aid in the selection of antibiotics.
Routine Lab Tests
CBC
- RBC: Anemia
- WBC: Significant leukocytosis (with left shift), leukopenia may present in cases of atypical pneumonia
- Platelets: Thrombocytopenia
Electrolytes
- Electrolytes are particularly helpful but hyponatremia may be present in cases of Legionella
Inflammatory biomarkers
- Erythrocyte sedimentation rate: Elevated
- C-reactive protein: Elevated
RFTs
- BUN: elevated
Arterial Blood Gas
- Hypoxia
- Respiratory acidosis (pH <7.2, bicarbonate <22 mEq/L)
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
Other Lab Tests
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
Polymerase Chain Reaction
- PCR results are very rapid and sensitive for detection of bacteria[2]
Urine Antigen
- Urine antigen samples are not often used, but may assist in the diagnosis of Legionella[3]
Bronchoalveolar Lavage
- BAL is especially helpful in determining the presence of bacterial pneumonia in non-immunocompromised and mechanically ventilated patients[4]
References
- ↑ "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.
- ↑ Couturier MR, Graf EH, Griffin AT (2014). "Urine antigen tests for the diagnosis of respiratory infections: legionellosis, histoplasmosis, pneumococcal pneumonia". Clin Lab Med. 34 (2): 219–36. doi:10.1016/j.cll.2014.02.002. PMID 24856525.
- ↑ Sanchez Nieto JM, Carillo Alcaraz A (1995). "The role of bronchoalveolar lavage in the diagnosis of bacterial pneumonia". Eur J Clin Microbiol Infect Dis. 14 (10): 839–50. doi:10.1007/BF01691489. PMC 7102128 Check
|pmc=value (help). PMID 8605896.