Which lab tests are performed in the workup of pediatric pneumococcal infections?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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The following laboratory studies are indicated in patients with pneumococcal infections:

  • White blood cell (WBC) count and differential

  • Antigen tests (cerebrospinal fluid [CSF], urine)

  • Gram stain (CSF, synovial fluid, pleural fluid)

  • Culture (blood, CSF, pleural fluid, middle ear effusion, synovial fluid)

Specific testing recommendations for particular clinical syndromes are as follows:

  • OM or sinusitis – Tympanocentesis and bacterial cultures of middle ear fluid if chronic OM is refractory to antibiotics

  • Sinusitis – Culture of sinus fluid if sinusitis is refractory to antibiotics

  • Occult bacteremia – Culture of blood (≥2 mL)

  • Pneumonia – Blood culture; sputum cultures are difficult to obtain from children, and results may be falsely positive

  • Meningitis (suspected) – Lumbar puncture with CSF analysis (cell count, protein levels, glucose levels, Gram stain, culture; antigen tests are needed only in cases of antibiotic pretreatment); blood culture

  • Osteomyelitis or septic arthritis – Surgical biopsy or joint aspiration; culture of fluid or bone; blood culture

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