Albert stain Throat swab

Bacterial/ Viral

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No Fasting Required

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Detects diphtheria bacilli from throat swab.

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Albert Stain Throat Swab - Comprehensive Medical Test Guide

Why is it done?
- Detects diptheroid organisms and Corynebacterium diphtheriae, a bacterium that produces a potent exotoxin responsible for diphtheria infection
- Identifies toxin-producing bacteria in patients presenting with symptoms of diphtheria including sore throat, pseudomembrane formation, and respiratory compromise
- Performed when acute pharyngitis with characteristic gray or yellowish membrane is observed or when diphtheria is clinically suspected
- Used for epidemiologic surveillance and confirmation in unvaccinated or partially vaccinated populations
- Albert staining specifically visualizes metachromatic granules (Babes-Ernst granules) within the bacterial cytoplasm, which appear as dark-staining inclusions
Normal Range
- Negative Result: No growth of Corynebacterium diphtheriae or diptheroid organisms detected on culture; no metachromatic granules visualized on Albert stained smear
- Normal Interpretation: Absence of diphtheria-causing organisms; patient is not infected with toxigenic C. diphtheriae
- Units: Qualitative (presence or absence); microscopic observation of staining patterns
- Reference Standard: Smear with no bacterial organisms or non-diphtheria corynebacteria without characteristic metachromatic granule staining pattern
Interpretation
- Positive Result: Gram-positive bacilli with characteristic metachromatic granules (appearing as deeply stained dots or bars) are present; indicates presumptive identification of Corynebacterium diphtheriae; toxin testing and molecular confirmation should follow
- Negative Result: No diptheria organisms identified; rules out diphtheria as cause of current symptoms; suggests alternative bacterial or viral pharyngitis
- Factors Affecting Results:
- Improper specimen collection or delayed transport may result in false negatives
- Prior antibiotic therapy may reduce bacterial yield and sensitivity
- Inadequate staining technique or improper smear preparation can affect visualization of metachromatic granules
- Presence of nontoxigenic diphtheroids requires toxin confirmation testing for definitive diagnosis
- Clinical Significance:
- Positive result warrants immediate clinical attention and initiation of antitoxin therapy without waiting for culture confirmation
- High specificity when characteristic morphology and staining pattern are observed
Associated Organs
- Primary Organ System:
- Respiratory and upper airway mucosa (pharynx, larynx, trachea)
- Oropharynx and surrounding lymphoid tissue
- Associated Diseases and Conditions:
- Diphtheria (Faucial or Classical form): Characterized by pseudomembrane, severe pharyngitis, lymphadenopathy with 'bull neck' appearance
- Laryngeal diphtheria: Airway involvement with stridor and respiratory distress
- Nasopharyngeal diphtheria: Mild local symptoms with high transmissibility
- Potential Complications:
- Myocarditis: Toxin-induced cardiac inflammation and arrhythmias
- Neuropathy: Cranial and peripheral nerve involvement, potentially causing paralysis
- Airway obstruction: Membrane extension and edema causing respiratory failure
- Secondary bacterial infection of affected areas
Follow-up Tests
- Confirmatory Tests:
- Toxin production testing (in vitro or in vivo Elek test) to confirm toxigenic strains
- Polymerase Chain Reaction (PCR) for definitive identification and toxin gene detection
- Culture on selective media (Loeffler medium or tellurite-containing media) for growth confirmation
- Clinical Monitoring Tests:
- Electrocardiography (ECG) to assess cardiac involvement and myocarditis
- Cardiac enzymes (troponin, CK-MB) if myocarditis suspected
- Blood cultures to exclude bacteremia or secondary infections
- Neurological assessment and examination for manifestations of neuropathy
- Complementary Tests:
- Serological testing for diphtheria antibodies in vaccinated individuals
- Nasopharyngeal and cutaneous culture if those sites involved
- Monitoring Frequency:
- Post-diagnosis: Repeat throat cultures 2 weeks after antibiotic completion to confirm organism eradication
- Close contacts: Screen with throat culture regardless of vaccination status
Fasting Required?
- Fasting Requirement: NO - Fasting is not required for throat swab collection
- Patient Preparation:
- Avoid eating or drinking for 15-30 minutes prior to specimen collection to minimize saliva dilution of organisms
- Do not use antiseptic throat lozenges or gargles before collection
- Avoid throat irrigation or mouthwash immediately before specimen collection
- Special Instructions:
- Specimen must be collected from the area behind the tonsils or from pseudomembrane if visible; gentle but adequate contact with mucosa is essential
- Use sterile swab (typically dacron or rayon); avoid cotton swabs which may inhibit organism growth
- Place specimen in appropriate transport medium (Loeffler medium or enriched holding medium) and maintain at room temperature
- Transport to laboratory promptly, preferably within 2 hours of collection for optimal organism viability
- Medications to Avoid:
- No antimicrobial throat lozenges, sprays, or topical antiseptics for at least 1 hour before collection
- Systemic antibiotics do not need to be withheld but should be noted on specimen requisition as they may reduce bacterial yield

How our test process works!