Sterile Body Fluids

Question 1

Sterile body fluids

Answer 1

Pleural fluid
Peritoneal fluid
Pericardial fluid
Synovial (Joint) fluid
CONTAIN NO NORMAL FLORA

Question 2

Pleural fluid

Answer 2

• between lungs and chest wall

- organisms isolated here are pneumonia associated (S. pneumo, S. aureus, H. flu, Enterics, Pseudomonas, TB)

Question 3

Transudate

Answer 3

• good guy
• fluid passed through membrane or extracted from tissues
• from renal, hepatic or cardiac disease

Question 4

Exudate

Answer 4

• bad guy
• fluid from blood vessels in adjacent spaces
• associated with infection (contains WBC’s)
• bloody fluid associated with malignancy

Question 5

Empyema

Answer 5

• purulent exudate
• pus in body cavity
• secondary to pneumonia

Question 6

Effusions

Answer 6

• fluid escaping into a body space or tissue

- transudate and exudate

Question 7

Peritoneal fluid

Answer 7

• between abdominal wall and organs
• small amount of fluid is normal
• ascites: increased fluid in cavity due to infection or inflammation
• ascites fluid contains increased WBC’s and proteins

Question 8

Peritoneal fluid organisms

Answer 8

• gain entry via bowel perforation, surgery, trauma

- primary and secondary peritonitis, intra-abdominal abscesses, peritoneal dialysis fluid

Question 9

Primary peritonitis

Answer 9

• age dependent
• kids: S. pneumo, Group A strep, Enterics, Staph
• adults: E. coli, S. pneumo, Group A strep, N. gonorrhoeae, Chlaymdia (sexually active women)

Question 10

Secondary peritonitis

Answer 10

• due to surgery, traumatic injury, loss of bowel wall integrity
• organisms are PID-associated (N. gonorrhoeae, Chlamydia, anaerobes)

Question 11

intra-abdominal abscesses (organisms)

Answer 11

• anaerobes (B. frag, Clostridium)
• Enterobacteriaceae
• Strep, Enterococcus

Question 12

Infection associated with peritoneal dialysis fluid (organisms)

Answer 12

• S. epi and S. aureus (most common)

- Strep, GNR’s, etc.

Question 13

Pericardial fluid

Answer 13

• between epicardium and pericardium
• normally clear fluid
• organisms: Viruses (usually), parasites, bacteria, fungi, non-infectious fluid buildup)

Question 14

Synovial fluid

Answer 14

• joint fluid
• secondary to hematogenous spread of bacteria
• bone infection, PROSTHETIC DEVICES

Question 15

Synovial fluid (organisms)

Answer 15

• S. aureus (70%)
• N. gonorrhoeae in young adults
• H. flu in kids < 2
• Group A and B strep, S. pneumo, B. frag, Fusobacterium

Question 16

Prosthetic devices (organsims)

Answer 16

• gain entry during surgery

- S. epi, CoNS, Coryne, Propionibacterium, S. aureus

Question 17

Bone biopsy

Answer 17

• osteomyelitis (bone infection)
• # 1 cause is S. aureus secondary to bacteremia
• Salmonella, Haemophilus

Question 18

Tissue

Answer 18

• work in hood

- Brucella, Legionella, Listeria

Question 19

Pleural fluid collection

Answer 19

• thoracentesis (needle aspiration), at least 10mL
• normally contains 300 WBC’s/mL
• special media: Chlamydia, viruses, Neisseria and Haemophilus (chocolate)

Question 20

Peritoneal fluid collection

Answer 20

pericardiocentesis

Question 21

Synovial fluid collection

Answer 21

• collected by aspiration

- inoculate several plates

Question 22

Bone marrow aspiration

Answer 22

• Brucella (Brucella agar)

- Histoplasma

Question 23

Bone biopsy (organisms sought)

Answer 23

• hematogenous spread: S. AUREUS, Salmonella, Haemophilus, Pseudomonas, Enterics
• Bites: Eikenella, Pasteurella

Question 24

VP positive Enterobacteriaceae

Answer 24

Klebsiella, Enterobacter, Hafnia, Serratia

Question 25

H2S positive Enterobacteriaceae

Answer 25

Salmonella, Proteus, Edwardsiella, Citrobacter

Question 26

Non-motile Enterobacteriaceae

Answer 26

Shigella, Klebsiella, Yersinia

Question 27

PAD positive Enterobacteriaceae

Answer 27

Proteus, Providencia, Morganella