A 44-year-old male presents with a fever, a cough productive of brownish sputum, rigors and lethargy for seven days. A chest x-ray reveals a right middle lobe infiltrate and a right-sided pleural effusion. A thoracentesis is performed. Which of the following results from the pleural fluid analysis would be most characteristic of acute pneumonia?
- pleural fluid: serum LDH ratio >0.6
- pleural fluid specific gravity < 1.006
- pleural fluid without protein
- pleural fluid without LDH
- pleural fluid: serum protein ratio <0.5
Answer: A
Pleural fluid: serum LDH ratio >0.6
The question suggests bacterial pneumonia. The pleural fluid should have high LDH (pleural > serum), a high specific gravity (lots of "stuff' in the fluid), a large amount of protein (WBC's, bacteria, and "stuff)
Know Your Content Blueprint
Bacterial pneumonia is covered as part of the PANCE Pulmonary Blueprint
Review Topic: Bacterial pneumonia (ReelDx)