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. 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, | 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== | ||
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'''CBC''' | '''CBC''' | ||
#RBC: [[Anemia]] | #[[RBC]]: [[Anemia]] | ||
#WBC: Significant [[leukocytosis]] (with left shift), leukopenia may present in cases of atypical pneumonia | #[[WBC]]: Significant [[leukocytosis]] (with left shift), leukopenia may present in cases of atypical pneumonia | ||
#Platelets: [[Thrombocytopenia]] | #[[Platelets]]: [[Thrombocytopenia]] | ||
'''Electrolytes''' | '''[[Electrolyte|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''' | '''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''' | '''[[Renal function tests|RFTs]]''' | ||
*BUN: elevated | *[[BUN]]: elevated | ||
'''Arterial Blood Gas''' | '''[[ABG|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''' | '''[[Pulse oximetry]]''' | ||
*< 92% indicates severe hypoxia | *< 92% indicates severe hypoxia | ||
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'''Blood Culture''' | '''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]]''' | ||
*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 bacteria|gram positive]], [[Gram-negative bacteria|gram negative]], or does not have a cell wall as in the case of ''[[Mycoplasma]]'' | ||
'''Sputum samples''' | '''[[Sputum culture|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''' | '''[[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> | *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> | ||
Revision as of 04:14, 29 January 2022
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Bacterial pneumonia Microchapters |
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Bacterial pneumonia laboratory findings On the Web |
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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. 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
- 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
- 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
- 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
- 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]