Bacterial pneumonia laboratory findings: Difference between revisions
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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. | 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. | ||
== | ==Lab Tests== | ||
<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=30020693 | doi= | pmc= | url= }} </ref> | <ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume= | issue= | pages= | pmid=30020693 | doi= | pmc= | url= }} </ref> | ||
'''CBC''' | |||
#RBC: [[Anemia]] | #RBC: [[Anemia]] | ||
| Line 15: | Line 15: | ||
#Platelets: [[Thrombocytopenia]] | #Platelets: [[Thrombocytopenia]] | ||
'''Electrolytes''' | |||
*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''' | |||
*[[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) | ||
'''RFTs''' | |||
*BUN: elevated | *BUN: elevated | ||
'''Arterial Blood Gas''' | |||
*Hypoxia | *Hypoxia | ||
*[[Respiratory acidosis]] (pH <7.2, bicarbonate <22 mEq/L) | *[[Respiratory acidosis]] (pH <7.2, bicarbonate <22 mEq/L) | ||
'''Pulse oximetry''' | |||
*< 92% indicates severe hypoxia | *< 92% indicates severe hypoxia | ||
'''Blood Culture''' | |||
*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 can identify if an organism is gram positive, 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, 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 | ||
*A common practice in hospitalized patients | *A common practice in hospitalized patients | ||
'''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> | *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> | ||
==References== | ==References== | ||
Revision as of 10:16, 11 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.
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 (> 100 mg/L)
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
- A common practice in hospitalized patients
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
- A common practice in hospitalized patients
Polymerase Chain Reaction
- PCR results are very rapid and sensitive for detection of bacteria[2]