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
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