Pericardial fluid culture
Culture - pericardial fluid
Pericardial fluid culture is a test performed on a sample of fluid from the sac surrounding the heart. It is done to identify organisms that cause infection.
Pericardial fluid Gram stain is a related topic.
The interior of the heart is composed of valves, chambers, and associated vessels.
During a pericardial fluid culture, 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the chest between the ribs into the pericardium (the thin sac that surrounds the heart) and a small amount of fluid is withdrawn. Samples of the fluid are placed in various culture media in the laboratory, and the media is observed for the growth of microorganisms. The test is performed when an infection of the heart is suspected or when a pericardial effusion is present.
How the Test is Performed
Some people may have a cardiac monitor placed before the test to check for heart disturbances. Patches called electrodes will be placed on the chest, similar to during an ECG. A chest x-ray or ultrasound may be done before the test.
The skin of the chest will be cleaned with antibacterial soap. A health care provider inserts a small needle into the chest between the ribs into the thin sac that surrounds the heart (the pericardium). A small amount of fluid is removed.
You may have an ECG and chest x-ray after the test. Sometimes the pericardial fluid is taken during open heart surgery.
The sample is sent to a lab. Samples of the fluid are placed on dishes of growth media to see if bacteria grow. It can take a few days to several (6 to 8) weeks to get the test results.
How to Prepare for the Test
You will be asked to not eat or drink anything for several hours before the test. You may have a chest x-ray or ultrasound before the test to identify the area of fluid collection.
How the Test will Feel
You will feel some pressure and discomfort when the needle is inserted into the chest and the fluid is removed. Your provider should be able to give you pain medicine so that the procedure does not hurt very much.
Why the Test is Performed
Your provider may order this test if you have a heart infection (myocarditis), signs of a heart sac infection, or a pericardial effusion (fluid buildup of the pericardium) with an unknown cause.
The test may also be done if you have or are suspected to have pericarditis.
Normal Results
A normal result means no bacteria or fungi are found in the fluid sample.
What Abnormal Results Mean
Abnormal results may be due to an infection of the pericardium. The specific organism causing the infection may be identified. More tests may be needed to determine the most effective treatments.
Risks
Complications are rare but include:
- Heart or lung puncture
- Infection
References
Banks AZ, Corey GR. Myocarditis and pericarditis. In: Cohen J, Powderly WG, Opal SM, eds. Infectious Diseases. 4th ed. Philadelphia, PA: Elsevier; 2017:446-455.
LeWinter MM, Cremer PC, Klein AL. Pericardial diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 86.
Maisch B, Ristic AD. Pericardial diseases. In: Vincent JL, Moore FA, Bellomo R, Marini JJ, eds. Textbook of Critical Care. 8th ed. Philadelphia, PA: Elsevier; 2024:chap 75.
Patel R. The clinician and the microbiology laboratory: test ordering, specimen collection, and result interpretation. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 16.
Version Info
Last reviewed on: 12/4/2022
Reviewed by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
