Streptococcus pneumoniae sepsis in a pleural effusion smear with concomitant Waldenstrom's macroglobulinemia.

Usually identification of the causative bacteria for an episode of sepsis is achieved using microbiological culture of blood or body fluid. In the case of pleural effusion and fever, a microscopic examination of the pleural effusion smear to identify the bacteria responsible should be performed immediately to optimize the selection of antibiotic therapy regimen.