Sterile Body Fluids Flashcards
Sterile body fluids
Pleural fluid Peritoneal fluid Pericardial fluid Synovial (Joint) fluid CONTAIN NO NORMAL FLORA
Pleural fluid
- between lungs and chest wall
- organisms isolated here are pneumonia associated (S. pneumo, S. aureus, H. flu, Enterics, Pseudomonas, TB)
Transudate
- good guy
- fluid passed through membrane or extracted from tissues
- from renal, hepatic or cardiac disease
Exudate
- bad guy
- fluid from blood vessels in adjacent spaces
- associated with infection (contains WBC’s)
- bloody fluid associated with malignancy
Empyema
- purulent exudate
- pus in body cavity
- secondary to pneumonia
Effusions
- fluid escaping into a body space or tissue
- transudate and exudate
Peritoneal fluid
- 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
Peritoneal fluid organisms
- gain entry via bowel perforation, surgery, trauma
- primary and secondary peritonitis, intra-abdominal abscesses, peritoneal dialysis fluid
Primary peritonitis
- age dependent
- kids: S. pneumo, Group A strep, Enterics, Staph
- adults: E. coli, S. pneumo, Group A strep, N. gonorrhoeae, Chlaymdia (sexually active women)
Secondary peritonitis
- due to surgery, traumatic injury, loss of bowel wall integrity
- organisms are PID-associated (N. gonorrhoeae, Chlamydia, anaerobes)
intra-abdominal abscesses (organisms)
- anaerobes (B. frag, Clostridium)
- Enterobacteriaceae
- Strep, Enterococcus
Infection associated with peritoneal dialysis fluid (organisms)
- S. epi and S. aureus (most common)
- Strep, GNR’s, etc.
Pericardial fluid
- between epicardium and pericardium
- normally clear fluid
- organisms: Viruses (usually), parasites, bacteria, fungi, non-infectious fluid buildup)
Synovial fluid
- joint fluid
- secondary to hematogenous spread of bacteria
- bone infection, PROSTHETIC DEVICES
Synovial fluid (organisms)
- S. aureus (70%)
- N. gonorrhoeae in young adults
- H. flu in kids < 2
- Group A and B strep, S. pneumo, B. frag, Fusobacterium
Prosthetic devices (organsims)
- gain entry during surgery
- S. epi, CoNS, Coryne, Propionibacterium, S. aureus
Bone biopsy
- osteomyelitis (bone infection)
- # 1 cause is S. aureus secondary to bacteremia
- Salmonella, Haemophilus
Tissue
- work in hood
- Brucella, Legionella, Listeria
Pleural fluid collection
- thoracentesis (needle aspiration), at least 10mL
- normally contains 300 WBC’s/mL
- special media: Chlamydia, viruses, Neisseria and Haemophilus (chocolate)
Peritoneal fluid collection
pericardiocentesis
Synovial fluid collection
- collected by aspiration
- inoculate several plates
Bone marrow aspiration
- Brucella (Brucella agar)
- Histoplasma
Bone biopsy (organisms sought)
- hematogenous spread: S. AUREUS, Salmonella, Haemophilus, Pseudomonas, Enterics
- Bites: Eikenella, Pasteurella
VP positive Enterobacteriaceae
Klebsiella, Enterobacter, Hafnia, Serratia
H2S positive Enterobacteriaceae
Salmonella, Proteus, Edwardsiella, Citrobacter
Non-motile Enterobacteriaceae
Shigella, Klebsiella, Yersinia
PAD positive Enterobacteriaceae
Proteus, Providencia, Morganella