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Body Fluid Analysis (Other) - Body Fluid

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Report in 4Hrs

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At Home

nofastingrequire

No Fasting Required

Details

To diagnose the cause of abnormal fluid accumulation in various body cavities

₹350₹1,750

80% OFF

Body Fluid Analysis (Other) - Body Fluid

  • Why is it done?
    • This test measures and analyzes body fluids other than blood, such as cerebrospinal fluid (CSF), synovial fluid, pleural fluid, peritoneal fluid, or pericardial fluid to diagnose infections, inflammatory conditions, malignancies, and metabolic disorders
    • Assists in evaluating patients with suspected meningitis, encephalitis, or other central nervous system infections
    • Helps identify joint inflammation, infection, or crystalline arthropathies in synovial fluid analysis
    • Detects malignant cells, infections, and inflammatory processes in pleural, peritoneal, or pericardial fluid
    • Ordered when patients present with signs and symptoms suggesting fluid accumulation in body cavities or central nervous system involvement
    • Typically performed as part of diagnostic workup for fever of unknown origin, joint pain, shortness of breath, chest pain, or abdominal pain
  • Normal Range
    • Cerebrospinal Fluid (CSF):
      • White Blood Cells (WBC): 0-5 cells/μL (normally lymphocytes)
      • Red Blood Cells (RBC): 0 cells/μL (normally absent)
      • Glucose: 40-70 mg/dL (or 50-80% of plasma glucose)
      • Protein: 15-45 mg/dL
      • Appearance: Clear and colorless
    • Synovial Fluid:
      • WBC: <2,000 cells/μL
      • Appearance: Clear to pale yellow
      • Crystals: Absent
      • Mucin clot: Good
    • Pleural/Peritoneal/Pericardial Fluid:
      • WBC: <1,000 cells/μL (predominantly lymphocytes)
      • Appearance: Clear to pale yellow
      • Malignant cells: Absent
      • Bacteria/Fungi: Not present
    • Negative cultures (bacterial, fungal, mycobacterial, viral as applicable)
    • Negative cytology for malignant cells
  • Interpretation
    • Elevated WBC Count (Pleocytosis):
      • Lymphocytic predominance (>50% lymphocytes): Suggests viral meningitis, tuberculosis, fungal infections, or autoimmune conditions
      • Neutrophilic predominance (>50% neutrophils): Indicates bacterial meningitis, acute inflammation, or early viral infection
    • Elevated Protein Levels in CSF (>45 mg/dL): Suggestive of infection, inflammation, tumor, subarachnoid hemorrhage, or neurological disease
    • Decreased Glucose in CSF (<40 mg/dL): Indicates bacterial meningitis, fungal meningitis, tuberculous meningitis, or malignancy
    • Positive Cultures: Identifies specific causative organisms and enables appropriate antibiotic therapy; indicates active infection
    • Presence of Crystals in Synovial Fluid: Monosodium urate crystals indicate gout; calcium pyrophosphate crystals suggest pseudogout
    • Turbid or Cloudy Appearance: Suggests high WBC count, bacterial infection, malignancy, or inflammatory condition
    • Bloody Fluid (Presence of RBCs): May indicate traumatic tap, hemorrhage, malignancy, or bleeding disorder; must differentiate from contamination
    • Malignant Cells Detected: Indicates metastatic cancer, lymphoma, or leukemia; confirms malignant involvement of body cavities or CNS
    • Exudative vs. Transudative Classification: Helps determine if fluid is due to inflammation/infection (exudate) or mechanical causes (transudate)
  • Associated Organs
    • Central Nervous System (Brain, Spinal Cord):
      • Bacterial meningitis, viral meningitis, tuberculous meningitis, fungal meningitis, encephalitis, neurosyphilis
    • Joints (Synovial Membrane):
      • Bacterial arthritis, viral arthritis, gout, pseudogout, rheumatoid arthritis, systemic lupus erythematosus, reactive arthritis
    • Pleura (Lung Lining):
      • Pneumonia, tuberculosis, malignancy, pulmonary embolism, heart failure, cirrhosis, nephrotic syndrome
    • Peritoneum (Abdominal Cavity):
      • Spontaneous bacterial peritonitis, peritoneal dialysis infections, peritoneal carcinomatosis, tuberculosis, appendicitis
    • Pericardium (Heart Lining):
      • Pericarditis, bacterial pericarditis, tuberculous pericarditis, pericardial malignancy, post-myocardial infarction syndrome
    • Potential complications from abnormal results: Meningitis can lead to brain damage or death; septic arthritis may cause permanent joint damage; malignant effusions indicate advanced cancer; untreated infections may progress to sepsis
  • Follow-up Tests
    • Blood Cultures: If CSF culture is positive, obtain concurrent blood cultures to determine if bacteremia is present and guide antibiotic therapy
    • PCR (Polymerase Chain Reaction): Rapid molecular detection of viral pathogens (HSV, VZV, enterovirus) or bacterial DNA in body fluids for faster diagnosis
    • Imaging Studies (CT/MRI): If CNS infection or pathology is suspected; helps identify complications like abscess, ventriculitis, or hydrocephalus
    • Repeat Lumbar Puncture: May be performed 24-48 hours after initial tap if clinical deterioration occurs or diagnosis remains unclear
    • Sensitivity/Resistance Testing: Conducted on positive cultures to guide optimal antibiotic selection
    • Immunological Tests (ANA, RF): If autoimmune conditions are suggested by fluid analysis
    • Lactate Measurement: Elevated levels in CSF suggest bacterial infection; helps differentiate from viral meningitis
    • Serum Glucose: Simultaneous serum glucose should be drawn with CSF glucose to calculate CSF-to-serum glucose ratio (normal <0.4)
    • Gram Stain and Procalcitonin: Initial evaluation to guide empiric therapy while awaiting culture results
    • Oncologic Markers: If malignancy is suspected, perform tumor marker studies or flow cytometry on fluid
    • Monitoring: Frequency depends on diagnosis; for infections, follow-up lumbar puncture may be needed to confirm sterilization of CSF with appropriate therapy
  • Fasting Required?
    • No fasting is required for body fluid analysis (CSF, synovial, pleural, peritoneal, or pericardial fluid collection)
    • The test involves direct collection of body fluid via invasive procedure (lumbar puncture, arthrocentesis, thoracentesis, paracentesis, or pericardiocentesis), not serum analysis
    • Patient Preparation:
      • Patient should empty bladder prior to procedure for abdominal procedures (paracentesis/arthrocentesis)
      • Informed consent must be obtained as these are invasive procedures with inherent risks
      • Baseline coagulation studies and platelet count should be checked before procedure to assess bleeding risk
      • Patient should refrain from anticoagulants and antiplatelet agents if clinically possible (coordinate with physician)
      • Patient positioned appropriately for procedure type (lateral decubitus for lumbar puncture, supine for arthrocentesis, etc.)
      • Skin prepared with antiseptic solution prior to needle insertion
      • Local anesthetic administered to reduce discomfort during procedure
    • Contraindications to Consider:
      • Signs of increased intracranial pressure (papilledema on fundoscopy) relative contraindication for lumbar puncture
      • Severe thrombocytopenia or active anticoagulation may increase bleeding risk
      • Skin infection at proposed puncture site contraindication

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