Professional Documents
Culture Documents
Pneumonia
Investigations
Possible diagnosis
lobar
patchy
interstitial
cavity
Large effusion
Microbiological
investigations
Full range of microbiological tests done in severe
CAP
Bacterial cultures are considered as the gold
standard to diagnose Pneumonia
1. blood culture and sputum gram stain and
cultures
2. urinary antigen tests for pneumococcus and
legionella infections.
3. Other atypical pneumonia microbes can be
investigated by PCR or direct
immunofluorescence (or other antigen detection
test)
4. Serology during epidemics of Mycoplasma.
Microbiological
investigations
5. AFB tests if symptoms of malaise , LOW ,night
sweats no response to initial antibiotics.
Microbiological
investigations
Treating without aetiology in severe
Pneumonia leads to
irrational use of antibiotics
unnessasary cost
SE and interactions of drugs
developing resistance to antibiotics
Conventional microbilogical
tests
These are done to identify typical organism
and not for atypical organism
Help to differentiate bacterial cause from
non bacterial cause
Useful for monitoring treatment and to
decide on antibiotic therapy and sensitivity.
Useful in
patients fail to respond to empirical antibiotics
Non severe Pneumonia admitted to hospital with purulent
sputum and has not received antibiotics previously
Severe Pneumonia
Blood culture
Ideally recommended for all patients with
CAP before treatment because this has a
prognostic value
But low sensitivity Only 10% have positive
values
Pleural fluid
When to do CT chest
Not indicated unless;
diagnosis is in doubt
severely ill patient with failing to respond
to treatment to exclude underlying
abscess , empyma, malignancy and other
interstitial involvement
Thank you