Pus Routine Microscopy

Bacterial/ Viral

Report in 12Hrs

At Home

No Fasting Required

Details

Measures presence and quantity of pus cells (polymorphonuclear leukocytes)

₹359₹500

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Pus Routine Microscopy - Comprehensive Medical Test Guide

Why is it done?
- Test measures the cellular and bacterial composition of purulent material (pus) collected from infected tissues, wounds, abscesses, or body cavities
- Diagnoses bacterial, fungal, or parasitic infections by identifying the causative organisms present in the pus sample
- Helps determine the severity and type of infection through assessment of white blood cell (WBC) count and differential
- Ordered when patients present with localized infections including abscesses, boils, infected wounds, drainage, or inflammatory conditions
- Used to guide appropriate antibiotic or antimicrobial therapy selection
- Performed when purulent discharge is evident from wounds, surgical sites, or drainage tubes
Normal Range
- WBC Count: Absence of significant numbers (Normal: <5-10 cells/HPF or <1000 cells/μL in non-infected material)
- RBC Count: Absent or minimal (Normal: <5 cells/HPF unless contaminated with blood)
- Bacteria: Absent (normal, sterile sample)
- Fungi: Absent
- Parasites: Absent
- Epithelial Cells: Few to none (if numerous, indicates contamination)
- Crystals: Absent
- Interpretation: Negative result indicates absence of infection or contamination; Positive result indicates active infection requiring treatment
Interpretation
- Elevated WBC Count (>25-50 cells/HPF or >5000 cells/μL):
  - Indicates active bacterial or pyogenic infection
  - Predominance of neutrophils suggests acute bacterial infection
  - Increased lymphocytes may indicate chronic or viral infection
- Presence of Bacteria:
  - Few bacteria: Early or partially treated infection
  - Moderate bacteria: Active infection requiring intervention
  - Numerous bacteria: Severe infection, high organism load
  - Gram-positive cocci: Staphylococcus, Streptococcus species
  - Gram-negative rods: Escherichia coli, Pseudomonas, Klebsiella species
- Fungal Elements:
  - Presence indicates fungal infection (Candida, Aspergillus, etc.)
  - More common in immunocompromised patients
- Presence of RBCs:
  - Indicates contamination with blood or recent hemorrhage in infected area
- Numerous Epithelial Cells:
  - Suggests poor sample collection or contamination; specimen validity questionable
- Factors Affecting Results:
  - Antibiotics administered before sample collection may reduce organism visibility
  - Improper sample collection or storage may compromise results
  - Immunocompromised status may alter inflammatory cell patterns
  - Stage of infection (acute vs. chronic) affects cell types and counts
Associated Organs
- Primary Organ Systems Involved:
  - Integumentary system (skin, subcutaneous tissue): abscesses, boils, cellulitis
  - Musculoskeletal system (muscle, bone): osteomyelitis, pyogenic infections
  - Genitourinary system: urogenital tract infections, prostatic abscesses
  - Gastrointestinal system: anal fistulas, perirectal abscesses
  - Respiratory system: lung abscesses, empyema
  - Nervous system: spinal epidural abscess, brain abscess
- Diseases Commonly Diagnosed:
  - Bacterial abscess (Staphylococcus aureus, Streptococcus pyogenes)
  - Infected wounds and surgical site infections
  - Cellulitis and pyogenic infections
  - Osteomyelitis (bone infections)
  - Tuberculosis (granulomatous infections)
  - Fungal infections (Candidiasis, Aspergillosis in immunocompromised)
  - Parasitic infections (toxoplasmosis, amebic abscess)
- Potential Complications from Abnormal Results:
  - Septicemia or bacteremia if infection spreads systemically
  - Septic shock in severe infections with delayed treatment
  - Tissue necrosis and permanent scarring if treatment delayed
  - Abscess rupture causing spread of infection to adjacent tissues
  - Antibiotic resistance if inappropriate therapy selected
Follow-up Tests
- Recommended Based on Positive Results:
  - Pus Culture and Sensitivity (C&S) - Identify specific organism and antibiotic susceptibility for targeted therapy
  - Gram Staining - Differentiate bacteria types (gram-positive vs. gram-negative) for preliminary identification
  - Special Staining (AFB for tuberculosis, fungal stains) - If specific organisms suspected
  - Blood Culture - If systemic infection or bacteremia suspected
  - Complete Blood Count (CBC) - Assess systemic inflammatory response
- Imaging Studies:
  - Ultrasound - Identify abscess location, size, and determine drainage necessity
  - CT or MRI - Evaluate deep-seated infections or complications
  - X-ray - For osteomyelitis or gas-forming infections
- Monitoring Tests:
  - Repeat pus microscopy after 48-72 hours of treatment to assess response
  - CRP (C-Reactive Protein) and Procalcitonin - Monitor infection severity and treatment response
  - ESR (Erythrocyte Sedimentation Rate) - Monitor chronic infection resolution
- Related Complementary Tests:
  - Serology or PCR - For specific pathogen identification (TB, fungal serology)
  - Wound Swab Culture - If drainage accessible without aspiration
Fasting Required?
- Fasting: NO - Fasting is not required for pus microscopy
- Sample Collection: Pus or exudate aspirated directly from the infected site
- Specimen Collection Method:
  - Needle aspiration - Preferred method for deep abscesses; use sterile needle and syringe
  - Swab collection - For surface wounds or drainage; use sterile cotton or synthetic swabs
  - Container: Sterile leak-proof container with appropriate transport media
- Patient Preparation:
  - No special pre-procedure fasting or dietary restrictions
  - Skin antisepsis required at collection site (typically 70% alcohol or povidone-iodine)
  - Allow antiseptic to dry (minimum 30 seconds) before sample collection
  - Avoid contamination with skin flora or surrounding tissue
- Medications to Avoid:
  - If possible, defer antibiotics until after sample collection for optimal organism recovery
  - If already on antibiotics, note the medication and duration on the specimen requisition
  - Avoid topical antiseptics or antibiotics on the collection site immediately before sampling
- Sample Handling & Transport:
  - Send sample to laboratory immediately (within 30 minutes if possible)
  - Maintain room temperature or incubate at 35-37°C during transport (do not refrigerate)
  - Ensure proper labeling with patient name, ID, collection date/time, and specimen source
  - Include relevant clinical information (infection site, antibiotics received, immunocompromised status)

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