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Use of reagent strips for the rapid diagnosis of spontaneous bacterial empyema.

J Clin Gastroenterol; 39(4): 278-81, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15758619
GOALS: To assess the utility of reagent strips for rapid diagnosis of spontaneous bacterial empyema in cirrhotic patients with hepatic hydrothorax.

BACKGROUND:

Analysis of ascitic fluid using reagent strips is a useful diagnostic test for spontaneous bacterial peritonitis.

METHODS:

A reagent strip for leukocyte esterase designed for the testing of urine was used to evaluate pleural fluid analysis in 47 nonselected thoracenteses in 28 cirrhotic patients with hepatic hydrothorax.

RESULTS:

Twelve spontaneous bacterial empyemas were diagnosed. Simultaneous spontaneous bacterial peritonitis was present in 7 of 10 cases in which ascites fluid was analyzed. When a test result of 3 or 4 was considered positive, sensitivity was 83% (10 of 12), specificity was 100% (35 of 35), and positive predictive value was 100%. When result of 2 or more was considered positive, sensitivity was 92% (11 of 12), specificity was 80% (28 of 35), and negative predictive value was 97%.

CONCLUSION:

Analysis of pleural fluid with reagent strips is a rapid, easy to use, and inexpensive tool for the diagnosis of spontaneous bacterial empyema in cirrhotic patients. A positive result should be considered an indication for antibiotic therapy.