Sputum culture

Evlauation Close monitoring of pulmonary status, blood gases (if indicated), oxygen saturation, chest x-ray, blood and sputum cultures, CBC, bronchoscopy with lavage (if needed)... 

Sputum culture and susceptibility are not obtained in the outpatient setting. The value of culturing is debated owing to the rapidity in which 5. pneumoniae dies in transport media and the inability to reliably or routinely culture atypical organisms. 

Effectiveness of TB therapy is determined by AFB smears and cultures. Sputum samples should be sent for AFB staining and microscopic examination (smears) every 1 to 2 weeks until two consecutive smears are negative. This provides early evidence of a response to treatment.28 Once on maintenance therapy, sputum cultures can be performed monthly until two consecutive cultures are negative, which generally occurs over 2 to 3 months. If sputum cultures continue to be positive after 2 months, drug susceptibility testing should be repeated, and serum concentrations of the drugs should be checked. 

Blood cultures x 2 from each access site (peripheral and central), urinalysis, urine culture, chest x-ray, sputum cultures... 

Sputum cultures The process of growing living material obtained from sputum (as bacteria or viruses) in prepared nutrient media. 

A 65-year-old male with a pneumonia has a sputum culture that is positive for a staphylococcal strain that is p-lactamase-positive. Which is the best choice of penicillin therapy in this patient ... 

An increased number of polymorphonuclear granulocytes in sputum often suggests continual bronchial irritation, whereas an increased number of eosinophils may suggest an allergic component. The most common bacterial isolates (expressed in percentages of total cultures) identified from sputum culture in patients experiencing an acute exacerbation of chronic bronchitis are as follows ... 

Relief of acute bronchospasm primary treatment of status asthmaticus or other acute episodes of asthma when intensive measures are required hypersensitivity to any ingredient systemic fungal infections persistently positive sputum cultures for Candida albicans. 

Active tuberculosis Rifabutin prophylaxis must not be administered to patients with active tuberculosis. HIV-positive patients are likely to have a nonreactive purified protein derivative (PPD) despite active disease. Chest X-ray, sputum culture, blood culture, urine culture, or biopsy of a suspicious lymph node may be useful in the diagnosis of tuberculosis in the HIV-positive patient. 

Contraindications Hypersensitivity to any corticosteroid or its components, persistently positive sputum cultures ior Candida albicans, primary treatment of status asth-maticus, systemic fungal infections, untreated localized infection involving nasal mu-... 

Two days later the patient returned to the clinic for a follow-up examination. The lab results indicated that his sputum culture was negative for growth, and the CBC showed a slight leukocytosis (increase in white blood cells). 

JS, a 46-year-old male patient, returned from India with cough, malaise, weight loss and night sweats. Sputum culture showed acid-fast bacilli and 3 days later Mycobacterium tuberculosis was isolated. 

A 40-year-old man with cough, shortness of breath, and fever progressed to respiratory failure. He had smoked cocaine for the previous 17 years. His tobacco history was not known. His medical history included recurrent respiratory tract infections. A chest X-ray and CT scan showed findings consistent with bilateral bullous emphysema with a right lung abscess. He was ventilated and given antibiotics but died from respiratory failure secondary to pneumonia. Sputum cultures... 

Therapy depends on etiology. In individuals who are suspected of having tuberculosis, diagnosis should make use of a purified protein derivative skin test, chest radiograph, and sputum cultures if necessary. These individuals should be referred for comanagement to their primary physician or to an infectious disease specialist. Though antituberculin agents are systemically administered, the ocular lesions are appropriately treated with topical steroids. In most instances, patients respond to 1% prednisolone acetate every 3 to 4 hours for the first day, subsequently tapered rapidly on the basis of the clinical response. 

Labs Lab tests revealed a WBC count of 22,000/ xL (98% PMNs) and Cr 2.0 mg/dL. Results of lumbar puncture showed the following WBC count 4000/ j,L, protein 120 mg/dL, and glucose 35 mg/dL. Results of studies on blood, OF, sputum cultures, and Gram stains are pending. AL has NKDA. 

Because the initial bronchitis following respiratory exposure is not infectious, patients will not benefit from administration of antibiotics. However, routine laboratory evaluation shonld include daily sputum cultures. Within the first several days after exposure, patients may develop a chemical pnenmonitis, reflected by fever, elevated white blood cell connts and pulmonary infiltrates, bnt this pnenmonitis is typically sterile. An infectious etiology is uncommon until the third or fourth day after exposure. Patients should receive antibiotics only after identification of a causative organism, not prophylactically (8,25,26). Patients with pnlmonary edema should not receive diuretics, because vesicant-caused pulmonary edema is not cardiogenic (3). 

Skin culture - positive Sputum culture - positive Urine culture - positive... 

Investigation of those overexposed to screening smokes should include, at least, chest radiograph, pulmonary function tests, arterial oxygen tension measurement, blood clinical chemistry, sputum culture, ophthalmic examination with slit-lamp biomicroscopy, and possibly measurement of intraocular pressure. If available, CT scan may be used to assess the severity of lung injury (Hsu et al., 2005). With some smokes, notably white phosphorus, there may be skin contamination with severe irritation and penetrating bums the management of white phosphoms skin burns is discussed in detail in Section VI.A.2. 

Thomassen MJ, Klinger JD, Badger SJ, et al. Cultures of thoracotomy specimens confirm usefulness of sputum cultures in cystic fibrosis. J Pediatr 1984 104 352-356. 

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