Bacterioscopic examination of pleural fluid and fluid in the pericardium

Bacterioscopic examination of the pleural fluid includes the coloration of smears according to Tsil-Nielsen. The appearance in the pleural fluid of tubercle bacillus is the most reliable sign of pleural tuberculosis. Mycobacteria in tubercular pleurisies are relatively rare in exudate. If there is a suspicion of a tuberculous process in the pleura, but with a negative bacterioscopic examination, a bacteriological study of the pleural fluid on the mycobacterium tuberculosis is necessary.

Detection of tubercle bacillus in the liquid from the pericardium is the most reliable sign of tuberculosis of the pericardium. Tuberculous mycobacteria with tubercular pericarditis are found in exudate relatively rarely.

Bacterioscopic examination of pleural fluid and fluid in the pericardium is a fairly simple but effective method of determining tuberculosis, as well as anaerobic or aerobic bacteria using microscopes of various modifications. Like any other study of liquids of serous cavities, a bacterioscopic examination of pleural fluid and fluid in the pericardium helps to solve such problems: 

• Definition of the main causative agent of pathology; 
• Exclusion of a certain group of mycobacteria; 
• Assessment of the degree of infection with bacteria of a serous environment.

In addition, bacterioscopy is sometimes crucial for the diagnosis of serious pathologies, when gonococci, pneumococci and other bacteria of this species, anaerobic microorganisms, tuberculosis bacilli are found in the puncture material (this is how the material is prepared for analysis), pericardial exudate or pleural effusion. Timely determination of the type of causative agent helps to clarify the cause, put a more accurate diagnosis, and therefore, start effective treatment.

Bacteriologic examination of pleural fluid and fluid in the pericardium is carried out according to the method of painting the material - smears or sediment of liquids. In a bacterioscopy of the pleural material, also for the study of pericardial fluid, a method of staining using the Tsily-Nielsen method is often used. This method is called direct, since it does not require bringing the material to a homogeneous consistency (homogenization) and any other treatment. Bacterioscopic examination of pleural fluid and fluid in the pericardium as microscopy of the material has existed for more than a century. Bacterioscopy allows you to identify fairly quickly all types of aerobic bacteria (microorganisms that multiply only in the presence of oxygen), as well as those that die in the air - anaerobic.

Also, bacterioscopic analyzes determine all acid-fast microorganisms - mycobacteria, they are also abbreviated for the sake of brevity - KUB (acid-fast bacteria).

[1], [2], [3], [4], [5]

How is a bacterioscopic examination of pleural fluid and fluid in the pericardium?

Bacterioscopy is performed using a special microscope, which shows microorganisms stained with carbolic dye. All results will be expressed in quantitative terms.

The KUB, that is, the bacteria that detect the bacterioscopy, differ from their "brethren" in that their cell wall can quickly take on the color of the medium and retain it. This is explained by the high content of lipids in the cell membrane of microorganisms. Bacteria absorb, adsorbed carbolic fuchsin, and so intense that the color can not be removed either alcohol or acids. The colored bacteria are subsequently treated with methylthioninium chloride - methylene blue. Under the microscope, the bacteria are visible as red elongated sticks against the background of blue. The method, named for its developers - Tsilya-Nielsen, is very specific and effective, despite its simplicity. Nevertheless, it should be borne in mind that such a technique is less indicative than the cultural methods, in addition, not all materials are suitable for research on Tsilyu-Nielsen.

Since the end of the last century, more precisely since 1989, many laboratories use a more perfect and informative method of bacterioscopy. Bacteriologic examination of pleural fluid and fluid in the pericardium is often carried out using fluorescence microscopy. This method is based on the same properties of bacteria to retain color firmly. For the fluorescent method, other dyes are used that provoke the fluorescence (luminescence) of bacteria under the ultraviolet.

Any pulmonary pathology, pericarditis requires a thorough and detailed diagnosis, because it is necessary to find out the etiology of these diseases and to determine the presence and type of harmful infections. Therefore, a bacterioscopic examination of pleural fluid and fluid in the pericardium usually involves the use of all modern microscopic methods and is one of the components of general diagnostic measures.