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Sputum by Conventional Method

Lung
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Report in 48Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Microscopy/culture.

₹1,014₹1,448

30% OFF

Sputum by Conventional Method - Comprehensive Medical Test Guide

  • Why is it done?
    • Test measures microscopic organisms and cellular material from the lower respiratory tract to diagnose pulmonary infections and diseases
    • Primary indications include suspected tuberculosis (TB), bacterial pneumonia, fungal infections, and viral respiratory infections
    • Ordered when patients present with persistent cough lasting more than 2-3 weeks, hemoptysis, fever, and night sweats
    • Commonly performed in patients with immunosuppression, HIV/AIDS, or suspicious chest X-ray findings
    • Used for diagnosis, treatment monitoring, and confirmation of cure in respiratory tract infections
    • Typically performed on first morning samples when bacterial load is highest, or during clinical suspicion of active infection
  • Normal Range
    • Normal Result: No pathogens identified; negative for acid-fast bacilli (AFB), bacteria, fungi, and viruses
    • Reference Values: Epithelial cells <10 per low power field (LPF); White blood cells <25 per LPF; Bacteria absent or normal flora only
    • Quality Assessment: Sample quality judged by epithelial cell count; <10 epithelial cells and >25 WBCs indicates good lower respiratory specimen
    • AFB Status: Negative or "No AFB seen on direct smear" indicates absence of tuberculosis organisms
    • Culture: No growth of significant organisms after appropriate incubation periods (typically 2-8 weeks for TB culture)
  • Interpretation
    • Positive AFB (Tuberculosis): 1+ to 4+ indicates probable active TB; patient is potentially infectious; requires immediate treatment initiation and isolation precautions
    • Bacterial Growth (Culture): Identifies specific organism causing infection (e.g., Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus); allows for targeted antibiotic therapy and sensitivity testing
    • Fungal Identification: Presence of organisms like Candida, Aspergillus, or Cryptococcus indicates fungal respiratory infection, especially in immunocompromised patients
    • Viral Identification: Detection of respiratory viruses (influenza, RSV, COVID-19) by PCR or immunofluorescence guides antiviral therapy decisions
    • Inadequate Sample: High epithelial cell count (>10 per LPF) indicates contamination with saliva; recollection needed for reliable results
    • Factors Affecting Results: Improper sample collection, prior antibiotic therapy, contamination with oral flora, timing of collection relative to infection onset, and patient compliance with collection instructions
    • Clinical Correlation: Results must be interpreted with clinical presentation, imaging findings, and patient risk factors; negative smear does not exclude TB or other infections
  • Associated Organs
    • Primary Organs: Lower respiratory tract including lungs, bronchi, and bronchioles; sample obtained through expectoration from trachea and lower airways
    • Pulmonary Tuberculosis: Primary disease detected; caused by Mycobacterium tuberculosis; most common indication for sputum testing globally
    • Bacterial Pneumonia: Identifies causative agents like Streptococcus pneumoniae, Klebsiella pneumoniae, and Pseudomonas aeruginosa; guides empiric antibiotic therapy
    • Fungal Respiratory Infections: Histoplasmosis, blastomycosis, coccidioidomycosis, and aspergillosis; particularly important in immunocompromised populations
    • Viral Infections: Influenza, respiratory syncytial virus (RSV), parainfluenza, adenovirus, coronavirus (COVID-19); important for public health surveillance and infection control
    • Chronic Pulmonary Diseases: Bronchiectasis, chronic obstructive pulmonary disease (COPD) with acute exacerbation, and cystic fibrosis complicated by infections
    • Complications of Abnormal Results: Respiratory failure requiring mechanical ventilation, systemic dissemination of infection, sepsis, empyema formation, lung abscess, and potential mortality without appropriate treatment
  • Follow-up Tests
    • Additional Sputum Samples: Multiple samples (typically 3-5) recommended for TB diagnosis; improves sensitivity from 60-80% with single sample to >95% with multiple samples
    • Chest X-ray: Imaging to visualize extent of pulmonary involvement, cavitary lesions, infiltrates, and assess treatment response over 2-6 months
    • Antimicrobial Susceptibility Testing (AST): Tests drug resistance patterns, especially for TB (isoniazid, rifampicin, fluoroquinolones) and multi-drug resistant (MDR) TB detection
    • Molecular Testing (PCR/GeneXpert): Rapid detection of TB and rifampicin resistance; more sensitive and specific than smear microscopy; results available within 2 hours
    • Blood Culture: Recommended in hospitalized patients with pneumonia and sepsis to identify bacteremia and guide systemic antibiotic therapy
    • Bronchoscopy with Bronchoalveolar Lavage (BAL): Performed when sputum samples cannot be obtained or are inadequate; useful in ventilated patients or those with lower lobe pneumonia
    • Tuberculin Skin Test (TST) or Interferon-Gamma Release Assay (IGRA): Complements sputum testing; QuantiFERON-TB Gold preferred for latent TB detection with higher specificity
    • Monitoring During Treatment: Repeat sputum samples at 2 weeks, 2 months, and end of intensive phase to assess bacteriologic response; negative sputum by 2 months indicates treatment effectiveness
    • Viral Testing: RT-PCR for influenza, RSV, COVID-19, and other respiratory viruses; rapid antigen detection assays may be performed simultaneously
  • Fasting Required?
    • Fasting Status: No, fasting is NOT required for sputum collection
    • Patient Preparation Instructions: Rinse mouth with water 1-2 minutes before collection to remove food debris and reduce oral contamination; do not use mouthwash or antiseptic solutions
    • Collection Timing: Best collected early morning (first thing upon waking) when sputum is most abundant and organism load is highest; at least 5 mL of sputum required
    • Pre-Collection Procedures: Drink warm water or tea (not hot) to help liquefy secretions; gentle coughing from deep in lungs produces better samples than saliva; patient should spit directly into sterile container
    • Medications - No Restrictions: No medications need to be discontinued before sputum collection; continue all regular medications as prescribed; do not delay collection for medication timing
    • Important Precautions: Patients should use N95 respiratory masks if TB is suspected; healthcare workers handling samples must use appropriate personal protective equipment (PPE); samples must be transported to laboratory promptly (within 4 hours) and stored at room temperature
    • Container Requirements: Sterile, leak-proof container with secure lid; labeled with patient identification, date, time of collection, and specimen type; may contain preservative if delayed transport expected

How our test process works!

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