Abstract
BACKGROUND: Detection of pneumococcal antigen may help to increase the rate of diagnosis of pneumococcal pneumonia. This study was designed to determine the value of rapid detection of pneumococcal antigen in pleural fluid from patients with community acquired pneumonia. METHODS: Thoracentesis was performed in patients suspected of having empyema and in patients with pneumonia of unknown aetiology. Pneumococcal capsular antigen was detected by latex agglutination and this method was compared with Gram staining and culture, specimens of pleural fluid being examined in parallel by the three methods. RESULTS: Pleural fluid was radiographically identified in 63 of 135 patients with community acquired pneumonia. In nine of 45 patients with pneumococcal pneumonia and pleural fluid pneumococci were identified by Gram stain in two and by culture in one specimen of pleural fluid, whereas antigen was detected in eight of these specimens. In 12 of 33 patients with pneumonia of other known aetiology only one pleural fluid specimen was antigen positive, providing a specificity of 92% for this test. Pleural fluid obtained from 12 of 58 patients with pneumonia of unknown aetiology yielded detectable antigen in seven cases. CONCLUSIONS: Detection of pneumococcal antigen by latex agglutination in pleural fluid may yield important and rapid information in patients with community acquired pneumonia.
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Selected References
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- Bartlett J. G., Gorbach S. L., Thadepalli H., Finegold S. M. Bacteriology of empyema. Lancet. 1974 Mar 2;1(7853):338–340. doi: 10.1016/s0140-6736(74)93079-7. [DOI] [PubMed] [Google Scholar]
- Boersma W. G., Löwenberg A., Holloway Y., Kuttschrütter H., Snijder J. A., Koëter G. H. Pneumococcal antigen persistence in sputum from patients with community-acquired pneumonia. Chest. 1992 Aug;102(2):422–427. doi: 10.1378/chest.102.2.422. [DOI] [PubMed] [Google Scholar]
- Boersma W. G., Löwenberg A., Holloway Y., Kuttschrütter H., Snijder J. A., Koëter G. H. Pneumococcal capsular antigen detection and pneumococcal serology in patients with community acquired pneumonia. Thorax. 1991 Dec;46(12):902–906. doi: 10.1136/thx.46.12.902. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coonrod J. D., Wilson H. D. Etiologic diagnosis of intrapleural empyema by counterimmunoelectrophoresis. Am Rev Respir Dis. 1976 May;113(5):637–641. doi: 10.1164/arrd.1976.113.5.637. [DOI] [PubMed] [Google Scholar]
- Fine N. L., Smith L. R., Sheedy P. F. Frequency of pleural effusions in mycoplasma and viral pneumonias. N Engl J Med. 1970 Oct 8;283(15):790–793. doi: 10.1056/NEJM197010082831505. [DOI] [PubMed] [Google Scholar]
- Helms C. M., Viner J. P., Sturm R. H., Renner E. D., Johnson W. Comparative features of pneumococcal, mycoplasmal, and Legionnaires' disease pneumonias. Ann Intern Med. 1979 Apr;90(4):543–547. doi: 10.7326/0003-4819-90-4-543. [DOI] [PubMed] [Google Scholar]
- Holmberg H., Krook A. Comparison of enzyme-linked immunosorbent assay with coagglutination and latex agglutination for rapid diagnosis of pneumococcal pneumonia by detecting antigen in sputa. Eur J Clin Microbiol. 1986 Jun;5(3):282–286. doi: 10.1007/BF02017782. [DOI] [PubMed] [Google Scholar]
- Lampe R. M., Chottipitayasunondh T., Sunakorn P. Detection of bacterial antigen in pleural fluid by counterimmunoelectrophoresis. J Pediatr. 1976 Apr;88(4 Pt 1):557–560. doi: 10.1016/s0022-3476(76)80005-4. [DOI] [PubMed] [Google Scholar]
- Light R. W., Girard W. M., Jenkinson S. G., George R. B. Parapneumonic effusions. Am J Med. 1980 Oct;69(4):507–512. doi: 10.1016/0002-9343(80)90460-x. [DOI] [PubMed] [Google Scholar]
- Light R. W. Parapneumonic effusions and empyema. Clin Chest Med. 1985 Mar;6(1):55–62. [PubMed] [Google Scholar]
- Macfarlane J. T., Miller A. C., Roderick Smith W. H., Morris A. H., Rose D. H. Comparative radiographic features of community acquired Legionnaires' disease, pneumococcal pneumonia, mycoplasma pneumonia, and psittacosis. Thorax. 1984 Jan;39(1):28–33. doi: 10.1136/thx.39.1.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ortqvist A., Jönsson I., Kalin M., Krook A. Comparison of three methods for detection of pneumococcal antigen in sputum of patients with community-acquired pneumonia. Eur J Clin Microbiol Infect Dis. 1989 Nov;8(11):956–961. doi: 10.1007/BF01967565. [DOI] [PubMed] [Google Scholar]
- Palmer D. L., Jones C. C. Diagnosis of pneumococcal pneumonia. Semin Respir Infect. 1988 Jun;3(2):131–139. [PubMed] [Google Scholar]
- Spencer R. C., Philp J. R. Effect of previous antimicrobial therapy on bacteriological findings in patients with primary pneumonia. Lancet. 1973 Aug 18;2(7825):349–350. doi: 10.1016/s0140-6736(73)93192-9. [DOI] [PubMed] [Google Scholar]
- Taryle D. A., Potts D. E., Sahn S. A. The incidence and clinical correlates of parapneumonic effusions in pneumococcal pneumonia. Chest. 1978 Aug;74(2):170–173. doi: 10.1378/chest.74.2.170. [DOI] [PubMed] [Google Scholar]
- Tugwell P., Greenwood B. M. Pneumococcal antigen in lobar pneumonia. J Clin Pathol. 1975 Feb;28(2):118–123. doi: 10.1136/jcp.28.2.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Venkatesan P., Macfarlane J. T. Role of pneumococcal antigen in the diagnosis of pneumococcal pneumonia. Thorax. 1992 May;47(5):329–331. doi: 10.1136/thx.47.5.329. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whitby M., Kristinsson K. G., Brown M. Assessment of rapid methods of pneumococcal antigen detection in routine sputum bacteriology. J Clin Pathol. 1985 Mar;38(3):341–344. doi: 10.1136/jcp.38.3.341. [DOI] [PMC free article] [PubMed] [Google Scholar]