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</noscript></div><div class="main"><div id="ency_summary"><p>Pericardial fluid Gram stain is a method of staining a sample of fluid taken from the pericardium to diagnose a bacterial infection. This is the sac surrounding the heart. The <a test="test" href="./007621.htm">Gram stain method</a> is one of the most commonly used techniques to rapidly identify the type of bacteria causing the infection.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>How the Test is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>A sample of fluid will be taken from the pericardium. This is done through a procedure called <a test="test" href="./003872.htm">pericardiocentesis</a>. Before this is done, you may have a heart monitor to check for heart problems. Patches called electrodes are put on the chest, similar to during an electrocardiogram (<a test="test" href="./003868.htm">ECG</a>). You will have a <a test="test" href="./003804.htm">chest x-ray</a> or <a test="test" href="./003336.htm">ultrasound</a> before the test.</p><p>The skin of the chest is cleaned with antibacterial soap. The doctor then inserts a small needle into the chest between the ribs and into the pericardium. A small amount of fluid is taken out.</p><p>You may have an ECG and chest x-ray after the procedure. Sometimes, the pericardial fluid is taken during open heart surgery.</p><p>A drop of the pericardial fluid is spread in a very thin layer on a microscope slide. This is called a smear. A series of special stains are applied to the sample. This is called a Gram stain. A laboratory specialist looks at the stained slide under the microscope, checking for the presence of bacteria.</p><p>The color, size, and shape of the cells help identify the bacteria, if present.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>How to Prepare for the Test</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>You will be asked not to eat or drink anything for several hours before the test. A chest x-ray or ultrasound may be done before the test to identify the area of fluid collection.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>How the Test will Feel</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>You will feel pressure and some pain as the needle is inserted into the chest and when the fluid is removed. Your health care provider will likely give you pain medicine so that the procedure is not too uncomfortable.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Why the Test is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Your provider may order this test if you have a heart infection (<a test="test" href="./000149.htm">myocarditis</a>), signs of a heart sac infection, or a <a test="test" href="./000182.htm">pericardial effusion</a> (fluid buildup of the pericardium) with an unknown cause.</p><p>The test may also be done if you have, or are suspected to have, pericarditis.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Normal Results</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>A normal result means no bacteria are seen in the stained fluid sample.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>What Abnormal Results Mean</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>If bacteria are present on the Gram stain, you may have an infection of the pericardium or heart. Blood tests and bacterial culture can help identify the specific organism causing the infection.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Risks</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Complications are rare but may include:</p><ul><li>Heart or lung puncture</li><li>Infection </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Gram stain of pericardial fluid</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9732t.jpg" alt="Pericardial fluid stain" title="Pericardial fluid stain" class="side-img"/><a href="../imagepages/9732.htm">Pericardial fluid stain</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Chernecky CC, Berger BJ. Pericardiocentesis - diagnostic. In: Chernecky CC, Berger BJ, eds. <em>Laboratory Tests and Diagnostic Procedures</em>. 6th ed. St Louis, MO: Elsevier Saunders; 2013:864-866.</p><p>LeWinter MM, Cremer PC, Klein AL. Pericardial diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. <em>Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine</em>. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 86.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/4/2022</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated 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.</p>
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