Hospital-acquired pneumonia laboratory findings: Difference between revisions
Jump to navigation
Jump to search
Created page with "{{Pneumonia}} '''Editor(s)-in-Chief:''' C. Michael Gibson, M.S., M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Philip Marcus, M.D., M.P.H.[mailto:pmarcus192@ao..." |
/* Infectious Diseases Society of America/American Thoracic Society consensus recommendation on diagnostics test for etiology of community-acquired pneumonia in adults. {{cite journal |author=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campb... |
||
| Line 8: | Line 8: | ||
{{cquote| | {{cquote| | ||
== | ==Major points and Recommendations for laboratory tests in adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia (DONOT EDIT) <ref name="pmid15699079">{{cite journal |author= |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |journal=[[American Journal of Respiratory and Critical Care Medicine]] |volume=171 |issue=4 |pages=388–416 |year=2005 |month=February |pmid=15699079 |doi=10.1164/rccm.200405-644ST |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=15699079 |accessdate=2012-09-13}}</ref>== | ||
{{cquote| | |||
}} | }} | ||
'''For Level of evidence and classes click [[ACC AHA Guidelines Classification Scheme|here]].''' | '''For Level of evidence and classes click [[ACC AHA Guidelines Classification Scheme|here]].''' | ||
Revision as of 16:05, 13 September 2012
|
Pneumonia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hospital-acquired pneumonia laboratory findings On the Web |
|
American Roentgen Ray Society Images of Hospital-acquired pneumonia laboratory findings |
|
Risk calculators and risk factors for Hospital-acquired pneumonia laboratory findings |
Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Philip Marcus, M.D., M.P.H.[2]
Overview
Current guidelines recommend a combination of chest Xray,laboratory data as well as clinical judgment in diagnosis and management of community acquired pneumonia.
Infectious Diseases Society of America/American Thoracic Society consensus recommendation on diagnostics test for etiology of community-acquired pneumonia in adults. [1] (DONOT EDIT)
{{cquote|
Major points and Recommendations for laboratory tests in adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia (DONOT EDIT) [2]
| “ |
|
” |
For Level of evidence and classes click here.
Lab diagnosis
Basic blood works
- Complete blood count (leucocytosis). In some people with compromised immunity, the white blood cell count may appear deceptively normal.
- Basic metabolic panel
- Used to evaluate kidney function when prescribing certain antibiotics
- Hyponatremia in pneumonia is thought to be due to excess anti-diuretic hormone produced when the lungs are diseased (SIADH)
Culture
Sputum culture
- Sputum gram stain and culture have poor yield. Sputum culture provides diagnostics information in roughly 1 in 5 patients only.
- Sputum cultures generally take at least two to three days, so they are mainly used to confirm that the infection is sensitive to an antibiotic that has already been started.
- A good sputum sample contains small number of squamous epithelial cells and a large number of PMNs.
Blood culture
- Blood cultures are not recommended for the outpatient management of CAP due to the low yield of pathogens.
- A blood sample may similarly be cultured to look for infection in the blood (blood culture). Any bacteria identified are then tested to see which antibiotics will be most effective.
Serology
- Specific blood serology tests for other bacteria (Mycoplasma, Legionella and Chlamydophila) can be done in conditions with strong suspicion of the causative organisms.
Oxygen monitoring
Special tests
- In more severe cases, (bronchoscopy) can be used collect fluid for culture.
- Special tests can be performed if an uncommon microorganism is suspected (such as testing the urine for Legionella antigen when Legionnaires' disease is a concern).
- HIV testing should be performed on all patients presenting with CAP (ages 13 to 75) in a medical setting.
- Respiratory secretions can also be tested for the presence of viruses such as influenza, respiratory syncytial virus, and adenovirus.
References
- ↑ Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083. Retrieved 2012-09-06. Unknown parameter
|month=ignored (help) - ↑ "Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. PMID 15699079. Retrieved 2012-09-13. Unknown parameter
|month=ignored (help)