Pathogen Community Acquired Nosocomial

Bacterial 70-80% 90%

Streptococcus pneumoniae 60-75% 3-9%

Hemophilus influenza 4-5%

Legionella sp. 2-5% Up to 25%

Staphylococcus aureus 1-5% 10-20%

Gram-negative bacilli Rare 50%

Atypical 10-20% Rare

Mycoplasma pneumoniae 5-18% -

Chlamydia psittaci 2-3% -

Coxiella burnetii 1% -

Virus 10-20% Rare

Influenza - 8%

Hantavirus - Rare

Pleural Effusion Fluids

PH 6.5

Glucose 73

Protein 3.2

Albumin 1.2

LDH 1092

C+S No growth

TEST Result Normal

HIV Negative Negative

IgG 991 700 – 1600

IgG subtypes I – II – III Pending -

IgM 75 40 – 230

IgA 472 70 – 400

C3 122 90 – 207

C4 21 17.4 – 52.2

Pleural fluid sample

Color Cloudy - Orange

WBC 350

Neut 93%

Lymph 2%

Mono 5%

Glucose Not done

PH Not done

C+S No growth

Pleural

space

anatomy

Pleural fluid

bacteriology

Pleural fluid

chemistryCategory

Risk

of outcome

Drainage

A0•Minima

l FF

•<10mm& Bx

C+S

unknown

&Cx

PH

U/K 1Very

lowNo

A1

•Small –

moderate

FF

•>10mm

& B0Negative

C+S

&C0

PH

>7.22 Low No

A2

•Large

FF

•Thick

pleura

•Hemi-

thoraxOR

B1Positive

C+S

ORC1

PH

<7.2

3 Mod Yes

B2 Pus 4 High Yes