Pneumonia laboratory findings: Difference between revisions
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(/* Urine Antigen Test {{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= ...) |
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==Other Laboratory Tests== | ==Other Laboratory Tests== | ||
===Urine Antigen Test <small><small><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=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24856525 }} </ref></small></small>=== | ===Urine Antigen Test <small><small><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=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24856525 }} </ref></small></small>=== | ||
* | *Usually used to diagnose [[Legionella]] disease. | ||
*Useful also in the diagnosis of pneumococcus pneumonia, with a sensitivity of 74.6% and an association with worst clinical outcome.<ref name="pmid24976113">{{cite journal| author=Zalacain R, Capelastegui A, Ruiz LA, Bilbao A, Gomez A, Uranga A et al.| title=Streptococcus pneumoniae antigen in urine: diagnostic usefulness and impact on outcome of bacteraemic pneumococcal pneumonia in a large series of adult patients. | journal=Respirology | year= 2014 | volume= 19 | issue= 6 | pages= 936-43 | pmid=24976113 | doi=10.1111/resp.12341 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24976113 }} </ref> | |||
*The presence of the antigen in urine can be detected in 24 hours since the onset of the symptoms | *The presence of the antigen in urine can be detected in 24 hours since the onset of the symptoms | ||
*The severity of [[Legionella]] disease increases the sensitivity of the urinary antigen test. | *The severity of [[Legionella]] disease increases the sensitivity of the urinary antigen test. | ||
Revision as of 18:52, 4 November 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Laboratory Tests
Routine Tests
Findings in routine blood tests are based on the severity of the disease and the cause, they can include the following:[1]
- Leukocytosis with left shift (in cases of bacterial pneumonia)
- Leukopenia (in cases of atypical pneumonia)
- Eosinophilia (in cases of eosinophilic pneumonia)
- Anemia
- Hyponatremia
- Thrombocytopenia
- Elevated BUN
- Findings of lactic acidosis (decreased HCO3, increased lactic acid levels)
Sputum Gram Stain and Culture
- Sputum samples should be obtained of all patients with productive cough.
- Gram-stain and culture should be performed to assess the causative agent and guide the therapy.
- In more than 80% of cases of pneumococcal pneumonia the sputum culture is positive.[2]
Blood Culture
- Blood culture may be positive in cases of hematogenous spread, such as S. aureus pneumonia, and in around one fourth of patients with pneumococcal pneumonia.
Other Laboratory Tests
Urine Antigen Test [3]
- Usually used to diagnose Legionella disease.
- Useful also in the diagnosis of pneumococcus pneumonia, with a sensitivity of 74.6% and an association with worst clinical outcome.[4]
- The presence of the antigen in urine can be detected in 24 hours since the onset of the symptoms
- The severity of Legionella disease increases the sensitivity of the urinary antigen test.
References
- ↑ Solomon, Caren G.; Wunderink, Richard G.; Waterer, Grant W. (2014). "Community-Acquired Pneumonia". New England Journal of Medicine. 370 (6): 543–551. doi:10.1056/NEJMcp1214869. ISSN 0028-4793.
- ↑ Musher, Daniel M.; Thorner, Anna R. (2014). "Community-Acquired Pneumonia". New England Journal of Medicine. 371 (17): 1619–1628. doi:10.1056/NEJMra1312885. ISSN 0028-4793.
- ↑ 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.
- ↑ Zalacain R, Capelastegui A, Ruiz LA, Bilbao A, Gomez A, Uranga A; et al. (2014). "Streptococcus pneumoniae antigen in urine: diagnostic usefulness and impact on outcome of bacteraemic pneumococcal pneumonia in a large series of adult patients". Respirology. 19 (6): 936–43. doi:10.1111/resp.12341. PMID 24976113.