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SPUTUM ANALYSIS

SPUTUM

• Spontaneous cough-material from alveoli.
• From mucus gland and goblet cells.
• Cellular material from respiratory tract.

PHYSICAL EXAMINATION

1. VOLUME

2. COLOUR TURBIDITY

3. ODOUR

4. SPUTUM VISCOSITY

5. CONSISTENCY

1. VOLUME

A. SMALL AMOUNT:

1. Lung abscess
2. Pneumonia
3. Tuberculosis B. COPIOUS AMOUNT:

• >200 ml/day in empyema, TB, bronchopleural fistula, bronchitis.

• Viscid, blood stained rusty: pneumonia, TB.

• Blood tinged: pulmonary infarction, lung carcinoma, TB, aortic aneurysm.

• Black colour: Carbon paricles in tract.

• Pink: Pulmonary edema

3. ODOUR

• Normally: Inoffensive in majority of cases.
• Offensive: in anaerobic bacteria. In bronchiectasis, abscess and gangrene of lung, necrosis.

4. SPUTUM VISCOSITY

1. BLOODY AND GELATINOUS (currant jelly):

• Klebseilla pneumoniae , pneumococcal pneumonia

1. STRINGY MUCOID SPUTUM (FROTHY):

• Asthma, bronchitis, oedema

MICROSCOPIC EXAMINATION

1. CHEESY MASSES 2. DITTRICH’S PLUGS
2. CHARCOT-LEYDEN CRYSTALS
3. FATTY ACID CRYSTALS 5. CURSCHMANN’S SPIRALS
4. CREOLA BODIES
5. EOSINOPHILS
6. ELASTIC FIBRES
7. CASTS
8. BRONCHOLITHS(LUNG STONE)
9. ASBESTOS BODIES(FERRUGINOUS BODIES)
10. FOREIGN BODIES

2. DITTRICH’S PLUGS

• Minute, foul smelling masses of bacteria, granular debris, fat globules, fatty acid crystals.

3. CHARCOT-LEYDEN CRYSTALS

• Colourless, slender, pointed both ends, pair of hexagonal pyramids joined at bases.
• Interact with eosinophil – eosinophilic inflammation in allergic reactions and parasitic infections.