Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1993 Dec;48(12):1227–1229. doi: 10.1136/thx.48.12.1227

Value of bacterial antigen detection in the diagnostic yield of transthoracic needle aspiration in severe community acquired pneumonia.

F Bella 1, J Tort 1, M A Morera 1, J Espaulella 1, J Armengol 1
PMCID: PMC464978  PMID: 8303628

Abstract

BACKGROUND--Transthoracic needle aspiration (TNA) with an ultrathin needle is a safe and highly specific procedure for obtaining a diagnosis in bacterial pneumonias, but its sensitivity is at best 70%. A study was performed to assess whether Streptococcus pneumoniae and Haemophilus influenzae type b antigen detection by latex agglutination from the TNA sample enhanced the diagnostic yield. METHODS--Blood cultures, TNA with an ultrathin needle (culture, Gram stain, and latex agglutination), serological tests, and pneumococcal antigen detection in the urine by counterimmunoelectrophoresis were performed in samples from 18 of 23 consecutive patients with severe community acquired pneumonia. RESULTS--The causative organism was identified in 16 cases (88%): S pneumoniae (10 cases), S pneumoniae plus H influenzae (two cases), Legionella pneumophila (three cases), and Mycoplasma pneumoniae (one case). The investigation of antigens by latex agglutination in the pulmonary aspirate increased the diagnostic yield of TNA from 50% to 78% and provided a rapid diagnosis (in less than two hours) with therapeutic implications in seven cases. Its effectiveness was not modified by prior antibiotic therapy. CONCLUSIONS--A latex agglutination test on the pulmonary aspirate enhances the diagnostic yield of TNA in severe community acquired pneumonia.

Full text

PDF
1227

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ajello G. W., Bolan G. A., Hayes P. S., Lehmann D., Montgomery J., Feeley J. C., Perlino C. A., Broome C. V. Commercial latex agglutination tests for detection of Haemophilus influenzae type b and Streptococcus pneumoniae antigens in patients with bacteremic pneumonia. J Clin Microbiol. 1987 Aug;25(8):1388–1391. doi: 10.1128/jcm.25.8.1388-1391.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ausina V., Coll P., Sambeat M., Puig I., Condom M. J., Luquin M., Ballester F., Prats G. Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain. Eur J Clin Microbiol Infect Dis. 1988 Jun;7(3):342–347. doi: 10.1007/BF01962334. [DOI] [PubMed] [Google Scholar]
  3. Farrington M., Rubenstein D. Antigen detection in pneumococcal pneumonia. J Infect. 1991 Sep;23(2):109–116. doi: 10.1016/0163-4453(91)91900-i. [DOI] [PubMed] [Google Scholar]
  4. Granados A., Podzamczer D., Gudiol F., Manresa F. Pneumonia due to Legionella pneumophila and pneumococcal pneumonia: similarities and differences on presentation. Eur Respir J. 1989 Feb;2(2):130–134. [PubMed] [Google Scholar]
  5. Holloway Y., Boersma W. G., Kuttschrütter H., Snijder J. A. Minimum number of pneumococci required for capsular antigen to be detectable by latex agglutination. J Clin Microbiol. 1992 Feb;30(2):517–519. doi: 10.1128/jcm.30.2.517-519.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Manresa F., Dorca J. Needle aspiration techniques in the diagnosis of pneumonia. Thorax. 1991 Aug;46(8):601–603. doi: 10.1136/thx.46.8.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Pachon J., Prados M. D., Capote F., Cuello J. A., Garnacho J., Verano A. Severe community-acquired pneumonia. Etiology, prognosis, and treatment. Am Rev Respir Dis. 1990 Aug;142(2):369–373. doi: 10.1164/ajrccm/142.2.369. [DOI] [PubMed] [Google Scholar]
  8. Pachon J., Prados M. D., Capote F., Cuello J. A., Garnacho J., Verano A. Severe community-acquired pneumonia. Etiology, prognosis, and treatment. Am Rev Respir Dis. 1990 Aug;142(2):369–373. doi: 10.1164/ajrccm/142.2.369. [DOI] [PubMed] [Google Scholar]
  9. Sippel J. E., Hider P. A., Controni G., Eisenach K. D., Hill H. R., Rytel M. W., Wasilauskas B. L. Use of the directigen latex agglutination test for detection of Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis antigens in cerebrospinal fluid from meningitis patients. J Clin Microbiol. 1984 Nov;20(5):884–886. doi: 10.1128/jcm.20.5.884-886.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Torres A., Serra-Batlles J., Ferrer A., Jiménez P., Celis R., Cobo E., Rodriguez-Roisin R. Severe community-acquired pneumonia. Epidemiology and prognostic factors. Am Rev Respir Dis. 1991 Aug;144(2):312–318. doi: 10.1164/ajrccm/144.2.312. [DOI] [PubMed] [Google Scholar]
  11. Zavala D. C., Schoell J. E. Ultrathin needle aspiration of the lung in infectious and malignant disease. Am Rev Respir Dis. 1981 Jan;123(1):125–131. doi: 10.1164/arrd.1981.123.1.125. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES