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Albert stain smear
Bacterial/ Viral
Report in 48Hrs
At Home
No Fasting Required
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Special stain for Corynebacterium diphtheriae.
₹562₹803
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Albert Stain Smear - Comprehensive Medical Test Guide
- Why is it done?
- Detects and identifies corynebacterium diphtheriae bacteria, which causes diphtheria, a potentially life-threatening respiratory infection
- Used to diagnose suspected diphtheria cases when patients present with characteristic pseudomembrane formation in the throat or nasopharynx
- Identifies characteristic metachromatic granules (Loeffler granules) within bacterial cells using special staining techniques
- Performed during acute illness when diphtheria is clinically suspected, typically within the first 3-7 days of symptom onset
- Assists in differentiating diphtheria from other causes of pharyngitis or upper respiratory infections
- Normal Range
- Normal Result: Negative - No corynebacterium diphtheriae bacteria detected on the smear preparation
- Absence of metachromatic granules in examined specimen indicates negative finding
- Positive Result: Positive - Corynebacterium diphtheriae bacteria with characteristic Loeffler granules identified
- The Albert stain produces blue-black bacteria with purple or red metachromatic granules at the poles or along the bacterial cell
- Presumptive Positive: Suggests probable diphtheria; must be confirmed with culture and toxin testing
- No quantitative values are reported; results are reported as positive, negative, or unable to assess
- Interpretation
- Negative Result: No diphtheria organisms detected; however, culture should still be obtained as sensitivity is not 100%. A negative smear does not rule out diphtheria.
- Positive Result: Strongly suggestive of corynebacterium diphtheriae infection. Immediate clinical intervention including antitoxin administration and antibiotic therapy should be initiated. This is presumptive evidence of diphtheria.
- Characteristic Appearance: Short, plump gram-positive rods with distinctive metachromatic granules appearing as darker-staining structures at cell poles or along the length of the bacillus
- Factors Affecting Results: Quality of specimen collection, timing of collection (best in first week of illness), prior antibiotic therapy (may reduce organism visibility), improper staining technique, and observer experience
- Sensitivity and Specificity: Sensitivity ranges from 50-90% depending on specimen quality and bacterial load. Specificity is high when metachromatic granules are clearly identified
- Clinical Decision Making: A positive smear warrants immediate clinical action. Treatment should not be delayed pending culture confirmation. A negative smear with strong clinical suspicion should still prompt empiric antitoxin and antibiotic therapy pending culture results.
- Associated Organs
- Primary Sites Involved: Throat and nasopharynx (most common respiratory diphtheria); can also involve nasal mucosa, larynx, trachea, and bronchi
- Organ Systems Affected: Respiratory system (primary), cardiovascular system (myocarditis and arrhythmias from diphtheria toxin), nervous system (cranial nerve palsies and neuropathies)
- Diseases Diagnosed: Diphtheria (caused by toxigenic corynebacterium diphtheriae), respiratory diphtheria with pseudomembrane formation, cutaneous diphtheria
- Potential Complications: Airway obstruction from pseudomembrane expansion, myocarditis with congestive heart failure, polyneuritis causing respiratory paralysis, cardiac arrhythmias, renal complications, toxic shock, and death if untreated
- Systemic Effects: Diphtheria toxin can cause systemic toxemia affecting cardiac conduction, causing peripheral neuropathy, and triggering inflammatory responses throughout the body
- Follow-up Tests
- Culture Confirmation: Loeffler's medium or tellurite agar culture should always be performed to confirm presumptive diagnosis from smear and to allow toxin testing
- Toxin Detection: Elek test or immunoassay to confirm toxin production by isolated organisms; essential for confirming toxigenic diphtheria
- Electrocardiography (ECG): Should be performed at diagnosis and serially during illness to detect cardiac involvement including myocarditis and arrhythmias
- Complete Blood Count (CBC): To assess for leukocytosis and overall systemic response to infection
- Chest Radiography: To assess for pseudomembrane extension to lower airways and identify pulmonary involvement
- Liver Function Tests (LFTs): To monitor for hepatic involvement from systemic toxemia
- Monitoring During Treatment: Repeat throat cultures 2 weeks after treatment completion to confirm organism clearance; ECG monitoring continues during and after acute illness
- Close Contact Screening: Albert stain smear and culture of close contacts recommended for case contacts to identify asymptomatic carriers
- Fasting Required?
- Fasting: No - Fasting is not required for Albert stain smear. This is a direct examination of throat or nasopharyngeal secretions.
- Patient Preparation: Patient should not eat, drink, or rinse mouth for 15-30 minutes before specimen collection to preserve organism viability
- Specimen Collection Timing: Can be obtained at any time of day; ideally collected in early morning or within first week of symptom onset
- Medications: Continue all regular medications. However, antibiotics may reduce organism recovery if already initiated; notify laboratory if patient has received antibiotics
- Special Instructions: Specimen should be obtained using a sterile swab (Dacron or cotton) from the pharyngeal membrane or nasopharynx. Avoid using wooden swabs. Collect material directly from the pseudomembrane or exudate if present. Specimen should be smeared on glass slide immediately or placed in appropriate transport medium.
How our test process works!
