Pericardial fluid culture

Alternative names
Culture - pericardial fluid

Definition
This is a laboratory test to isolate and identify organisms that cause infection from a specimen of pericardial fluid.

How the test is performed

The fluid must first be obtained from the sac surrounding the heart. In some people, a cardiac monitor may be placed prior to the test to monitor for heart disturbances. Patches called electrodes will be placed on the chest similar to an ECG. A chest X-ray or ultrasound may precede the test.

The skin of the chest will be cleansed with antibacterial soap. A trained physician, often a cardiologist, will obtain the sample. A small needle is inserted into the chest between the ribs into the pericardium, the thin sac that surrounds the heart, and a small amount of fluid is withdrawn.

There will be a sensation of pressure and some pain as the needle is inserted into the chest. An ECG and chest X-ray may also follow the procedure. Sometimes the pericardial fluid is obtained during open heart surgery.

Samples of the fluid are placed in various culture media in the laboratory. The media is observed for the growth of colonies of microorganisms (bacteria). Certain biochemical tests can identify certain organisms while others require serological tests or tissue culture to identify organisms.

The availability of results varies from a few hours to several weeks depending on the type of organism.

How to prepare for the test
Food and fluid will probably be restricted for several hours before the test. A chest X-ray or ultrasound may precede the test to identify the area of fluid collection.

For infants and children:
The preparation you can provide for this test depends on your child’s age and experience. For specific information regarding how you can prepare your child, see the following topics:

How the test will feel
There will be some pressure and discomfort associated with the removal of the fluid from the sac surrounding the heart. Your doctor should be able to give you enough pain medicine so that the procedure does not hurt very much.

Why the test is performed
The test is performed when an infection of the heart is suspected or when a pericardial effusion is present.

Normal Values
The absence of organisms is normal.

What abnormal results mean
An infection of the pericardium may be present. The specific organism may be identified. Sensitivity testing can determine effective antimicrobial therapy.

Additional conditions under which the test may be performed:

     
  • Pericarditis

What the risks are
There is a risk of puncturing the heart or the lung with this procedure. Introducing infection into the area is another rare, but potential risk.

Special considerations
Not applicable.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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