Bacterial pneumonia laboratory findings

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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 can help with a definitive diagnosis and aid in the selection of antibiotics.

Routine Lab Tests

CBC

1. RBC: Anemia
2. WBC: significant leukocytosis (with left shift), leukopenia may present in cases of atypical pneumonia
3. Platelets: Thrombocytopenia

Electrolytes

• Hyponatremia (in cases of Legionella)

Inflammatory biomarkers

• ESR: elevated
• C-reactive protein: elevated

RFTs

• BUN: elevated

Arterial Blood Gas

• Hypoxia
• Respiratory acidosis

Pulse oximetry

• < 92% indicates severe hypoxia

Blood Culture

• samples should be taken before administering antibiotics

Other Lab Tests

Gram staining

• may assist in determining the underlying bacteria

Sputum samples

• should be obtained when patient presents with a productive cough

Polymerase Chain Reaction

• provides sensitive and rapid results

Urine Antigen

• used to detect 'Legionella

Bronchoalveolar Lavage

• Especially helpful in determining the presence of bacterial pneumonia in non-immunocompromised and mechanically ventilated patients