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Sputum Routine

Bacterial/ Viral
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Report in 12Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Analysis of sputum (mucus coughed up from the respiratory tract) to assess for the presence of infection, inflammation, or abnormal cells

₹369₹450

18% OFF

Sputum Routine - Comprehensive Medical Test Guide

  • Why is it done?
    • Detects and identifies microorganisms (bacteria, fungi, viruses, parasites) present in the respiratory tract and lower airways
    • Diagnoses respiratory tract infections including pneumonia, bronchitis, and tuberculosis
    • Evaluates persistent cough lasting more than 3 weeks, particularly for suspected TB or chronic respiratory infections
    • Identifies drug-resistant organisms to guide appropriate antibiotic therapy
    • Monitors effectiveness of antimicrobial treatment in patients with diagnosed infections
    • Assesses immunocompromised patients with respiratory symptoms (HIV/AIDS, transplant recipients)
    • Typically performed when patients present with productive cough, fever, hemoptysis, or dyspnea
  • Normal Range
    • Culture Result: Negative (No pathogenic organisms isolated)
    • Gram Stain: Few to moderate epithelial cells (<10/low power field), numerous leukocytes (>25/low power field), minimal bacteria or yeast
    • Appearance: Clear to mucoid, white or slightly yellow color
    • Acid-Fast Bacilli (AFB) Smear: Negative (No tuberculosis bacilli detected)
    • Quality Assessment: Adequate specimen (good quality sputum, not saliva)
  • Interpretation
    • Negative Results: No pathogenic organisms cultured; suggests absence of significant bacterial, fungal, or mycobacterial infection; may indicate viral infection or non-infectious cause of respiratory symptoms
    • Positive Culture: Indicates presence of pathogenic organism (quantity and type specified); confirms respiratory tract infection; organism identification guides targeted antibiotic therapy
    • Gram Stain Findings: Gram-positive cocci in clusters suggest Staphylococcus; Gram-negative rods suggest Enterobacteriaceae or Pseudomonas; diplococcal appearance suggests Streptococcus pneumoniae
    • AFB Positive: Indicates presence of tuberculosis bacilli (Mycobacterium tuberculosis); patient is typically considered infectious; requires isolation precautions and TB treatment initiation
    • Inadequate Specimen: Predominantly saliva or insufficient volume; specimen cannot be reliably interpreted; recollection requested
    • Factors Affecting Results: Prior antibiotic therapy may reduce organism recovery; specimen collection timing relative to symptom onset; quality of specimen collection; contamination during collection; improper transport or storage
    • Antimicrobial Susceptibility: Results report sensitivity (organism susceptible to antibiotic) or resistance patterns; guides appropriate antibiotic selection and predicts treatment efficacy
  • Associated Organs
    • Primary Organ System: Respiratory system including lungs, bronchi, bronchioles, and trachea
    • Common Respiratory Infections Diagnosed: Bacterial pneumonia (Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus), Mycobacterium tuberculosis, atypical pneumonias (Mycoplasma, Chlamydia), fungal infections (Aspergillus, Candida), chronic bronchitis, bronchiectasis
    • Serious Conditions Associated: Tuberculosis, drug-resistant TB (MDR-TB, XDR-TB), hospital-acquired pneumonia (nosocomial infections), ventilator-associated pneumonia in ICU patients, community-acquired pneumonia
    • Secondary Complications: Sepsis (if untreated infection spreads systemically), acute respiratory distress syndrome (ARDS), pleuritis, empyema, lung abscess, progressive pulmonary disease
    • High-Risk Populations: Immunocompromised patients (HIV/AIDS, chemotherapy recipients, transplant patients), elderly patients, patients with chronic lung disease (COPD, asthma), diabetics, smokers, hospitalized patients
  • Follow-up Tests
    • If TB Suspected or Confirmed: Repeat AFB smears (minimum 3 consecutive samples on different days), TB culture confirmation, TB PCR/GeneXpert MTB/RIF for rapid detection and rifampicin resistance, chest X-ray, HIV testing, TB drug susceptibility testing
    • If Bacterial Pneumonia Identified: Blood cultures, complete blood count (CBC), chest X-ray, procalcitonin level, C-reactive protein (CRP), basic metabolic panel (BMP), oxygen saturation monitoring
    • For Immunocompromised Patients: CD4 count (HIV patients), Pneumocystis jirovecii PCR if PCP suspected, fungal culture and identification, viral respiratory panel, bronchoscopy with bronchoalveolar lavage if initial sputum non-diagnostic
    • Monitoring During Treatment: Serial sputum cultures to document organism clearance, repeat AFB smears for TB patients at week 2-4 to confirm treatment efficacy, follow-up chest imaging to document resolution
    • For Resistance Concerns: Comprehensive antimicrobial susceptibility testing, extended panel for multidrug-resistant organisms, consultation with infectious disease specialist, possible sputum induction for better specimen quality if initial samples inadequate
    • Complementary Tests: Viral respiratory panel (influenza, RSV, COVID-19, rhinovirus), sputum eosinophil count for asthma/eosinophilic bronchitis evaluation, spirometry for chronic airway disease assessment
  • Fasting Required?
    • Fasting Status: No - Fasting is NOT required for sputum collection
    • Patient Preparation Instructions: Patient should rinse mouth with water (not mouthwash) to remove food debris and reduce contamination with oral flora; early morning sample is preferred as sputum accumulates overnight
    • Collection Technique: Patient should inhale deeply and cough forcefully from deep in chest to expel sputum into sterile container; avoid spitting saliva; sample should contain at least 2-5 mL of sputum; multiple samples may be collected on different days for TB screening
    • Medications to Continue: All routine medications should be continued unless otherwise instructed by physician; continued use of mucolytics or inhalers does not interfere with collection
    • Medications to Avoid Before Collection: Do not use antimicrobial mouthwash before collection as it may reduce organism recovery; avoid eating or drinking for 15-30 minutes prior to collection for better sample quality; do not use cough suppressants if possible
    • Specimen Storage and Transport: Specimen should be transported to laboratory promptly; if delay anticipated, refrigerate at 2-8°C; do not freeze samples unless specifically instructed; maintain proper labeling with patient identification and collection time
    • Special Considerations: For patients unable to produce sputum spontaneously, induction with hypertonic saline nebulizer may be used; if TB suspected, collect at least 3 separate samples on consecutive days for optimal sensitivity; wear appropriate personal protective equipment (N95 mask) when collecting from suspected TB patients

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