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Digital Tools and AI for Teaching Learning and Research
Effusion
1. Effusion
Almugadam B Saad
Full name
Babiker Saad Almugadam Yousif
Lecturer of medical microbiologyLecturer of medical microbiology
Faculty of medical laboratory sciences
University of El Imam El Mahadi
Kosti-Sudan
MSc University of Khartoum
BSc University of El Imam El Mahadi
3. Definition
-It fluid collect in body cavities or joint. consider
ultra filtrate of plasma. Also called serous fluid
or body fluid.
Can transudate : Due to non inflammatory
be processbe process
or Exudate : Due to inflammatory process
can be infective or non
infective as in malignancy
4. -Differences between exudate and transudate
transudate exudate
presence : ormal in few amount abnormal
Apperance : clear pale yellow purulent or cloudy , may contain
blood
Clotting : not occur often occur
Cell count : few or absent many :
purulent : mostly pus
No purulent : mostly lymphocytesNo purulent : mostly lymphocytes
protein level: less than 30g/l more than 30g/l
5. Types of serous fluid :
- serous fluid include :
Pleural fluid
Peritoneal fluid
Pericardial fluid
Hydrocele fluid
Bursa fluid ?Bursa fluid ?
Amniotic fluid ?
6. Pleural fluid
-fluid normally fill pleural cavity ( space between lung and
inner chest wall) , It non purulent pleural effusion ,become
purulent pleural effusion (empyema) in case of pleurisy
(inflammation of pleura) .
Pulmonary infection
- causes of empyema Rheumatoid disease- causes of empyema Rheumatoid disease
include: Malignancy
SLE
Amoebic liver abscess
-Possible pathogen ?
7. Peritoneal fluid
- Fluid found normally in the peritoneal cavity (space
between peritoneum membranes) , become purulent and
accumulate (Ascitic fluid) in case of peritonitis .
-Ascities means accumulation of fluid in peritoneal cavity.
Usually cause by Enterococci , Clostridia , Mycobacteria and
Shistosomiasis.
-Possible pathogen according to age include :
Staphylococci -Possible pathogen ?
Children : Pneumonococcci
S.pyogen
Enterobacteriace
E.coli
Adult : B.fragilis
Clostridia
Enterococci
-In sexual active female can cause by N.gonorrhea and
C.trachomatis
8. Pericardial fluid
-Fluid normally found in pericardial space ( Space between
pericardium and epicardium ) , accumulate and become
purulent in case of purulent Pericarditis .
- Ateiology inlude : Bacteria , virus ,Fungi , SLE , Trauma ,
Uraemia , Rheumatic fever.
Mycoplasma , Mycobacteria , Chlamydiae
Bacteria : Staph auerusBacteria : Staph auerus
Pneumonococci , Viridans streptococci
Enterobacteriae
Candida
Fungi : Aspergillus
C.neoformaus
Virus : Enterovirus , Echovirus
Adenovirus , Influenza virus
9. Synovial fluid
-Fluid normally fill the joint , accumulate and become purulent
in case of synovitis and infective arthritis.
-Synovitis : inflammation of synovial membrane
-Arthritis : infection of joint
A- Mono-articular :involve one
Can be be : joint
B- Poly-articular : When many
joint involvedjoint involved
Staph auerus , E.coli
-Causative agent : N.gonorrhea , H.influnza
B.fragilis , Clostridia
Actinomycetes , Mycoplasma
Pneumococci , Viridans streptococci
- Osteomylitis ?
- Gouit and pseudogouit
10. Hydrocel fluid
-Fluid normally in the sac surround the testes , accumulate
certain condition like infection with W.bancrofti.
11. Lab diagnosis of effusion
- Specimen : Aspirate , which should dispense into 2 sterile
container .in first dispense 3(to detect clot) and in
second dispense 9 ml plus Tri Na citrate(use for
microscopy , culture and biochemical)
-Transportation: dispense 5 ml in thioglycolate broth or use
anaerobic transport vialsanaerobic transport vials
-Macro examination: 1-Appearance
2-Presence of clot container without
anticoagulant
3-Presence of blood
-Biochemical : 1-Protein estimation
2-Mucin clot test in case of joint effusion
12. - Micro examination :
1-Gram stain
2-ZN stain
3-KOH mount
4-Wet preparation to detect crystal when gout
suspect
5-Cytology smear when malignancy suspect
- Culture :
MaCconkey aerobic ,over nightMaCconkey aerobic ,over night
Routine : BA anaerobic up to 3 days
2 Blood culture broth
Sabroad agar if fungi suspect
Additional : Lj media if mycobacteria suspect
Sabroad agar if fungi suspect
