Sputum

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Sputum /'spju.t? m/ is mucus and is the name used for coughing (sputum) material from the lower airways (trachea and bronchi). In treatment, sputum samples are commonly used for naked eye examinations, microbiological investigations of respiratory infections, and cytological inquiry of the respiratory system. It is important that the patient not give a specimen that includes the slimy material from the inside of the nose. Sputum naked eye examination can be done at home by the patient to record various colors (see below). Any hint of yellow color indicates an airway infection (but does not indicate the type of organism that causes it). Such color hints are best detected when sputum is seen on very white backgrounds such as white paper, white pots, or white sink surfaces. The stronger the yellow color, the greater the likelihood of bacterial infection (bronchitis, bronchopneumonia, or pneumonia).

Video Sputum

Description

The best sputum samples contain less saliva, because saliva contaminates the sample with oral bacteria. This is especially true for samples for laboratory testing in cytology or microbiology. The adequacy of the specimen was assessed by the laboratory technologist by examining Gram stains or sputum cytologic stains. More than 25 squamous epithelial cells at low power microscopy examination strongly show salivary contamination.

When sputum specimens are coated out in microbiology, it is best to get the most visible portion of the sample as yellow pus onto the cotton. If there is blood in the sputum, it should also be on the cotton. Sputum microbiology samples were used to look for infections, such as Moraxella catarrhalis , Mycobacterium tuberculosis , Streptococcus pneumoniae , and Haemophilus influenzae . Other pathogens can also be found.

Purulent sputum contains pus, consisting of white blood cells, cellular debris, dead tissue, serous fluid, and viscous fluid (mucus). Purulent sputum is usually yellow or green. This is seen in cases of bronchiectasis, pulmonary abscess, advanced stage of bronchitis, or acute upper respiratory infection (common cold, laryngitis).

Maps Sputum

Interpretation

Sputum can (when checked with the naked eye):

Blood (hemoptysis)
1. Blood sputum is covered in blood - sore throat (larynx and/or trachea) or bronchi; lung cancer; erosion of other bleeding, boils, or tumors in the lower airways.
2. Sputum is pink - sputum is evenly mixed with blood from the alveoli and/or small peripheral bronchus.
3. Massive blood - cavitary or tumor tuberculosis such as lung cancer, or lung abscess; bronchiectasis; pulmonary infarction; pulmonary embolism.
Green or greenish - indicating a long respiratory infection (green due to degenerative changes in cellular debris) such as in pneumonia, pulmonary abscess rupture, chronic bronchitis infection, and infected bronchiectasis or cystic fibrosis.
Stained color - usually caused by pneumococcal bacteria (in pneumonia), pulmonary embolism, lung cancer or pulmonary tuberculosis.
Brownish - chronic bronchitis (greenish/yellow/brown); chronic pneumonia (whitish chocolate); tuberculosis; lung cancer.
Yellow, purulent yellow - contains pus. "The sputum color of patients with acute cough and no underlying chronic lung disease does not imply therapeutic consequences such as antibiotic prescriptions." Colors can provide clues to effective treatment in patients with chronic bronchitis:
1. Yellow-green (mucopurulent) indicates that treatment with antibiotics may reduce symptoms. The green color is caused by degrean neutrophil verdoperoxidase.
The whiteness of the gray sputum color against a white background (such as a white sink surface) tends to show a good specimen of a person who is dehydrated, and/or from an older person, and/or specimen with mixed, simple amounts of eosinophils and may be some acute inflammatory neutrophil cells (this latter option tends to suggest chronic allergic bronchitis).
Appearance of white, milk, or opaque (mucus) means that antibiotics tend to be less effective in treatment because of the greater likelihood of viral or allergic infection (even asthma... thick sputum) rather than responsive antibiotic micro-organisms.
Foamy white - probably derived from early-stage pulmonary edema.
Pink frothy - may show more severe pulmonary edema.
Clear - pulmonary embolism (obviously foaming); COPD chronic obstructive pulmonary disease (sunny to grayish); viral respiratory infections (obviously for whitish & sometimes slightly yellow); asthma (thick and yellowish white).