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Bronchoalveolar lavage (BAL), also known as bronchoalveolar washing, is a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amount of fluid introduced and then collected for examination.
A sputum culture is a test to detect and identify bacteria [1] or fungi that infect the lungs or breathing passages. Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, fresh morning sample is preferred for the bacteriological examination of sputum. [ 2 ]
Blood-streaked sputum –an indicator of possible inflammation of the throat (larynx and/or trachea) or bronchi; lung cancer; other bleeding erosions, ulcers, or tumors of the lower airway. Pink sputum – it indicates sputum evenly mixed with blood from alveoli and/or small peripheral bronchi as is seen in potential pulmonary edema.
Sampling of sputum from the lungs for sputum culture. It can be performed by special techniques of coughing, or by a protected specimen brush (PSB), [1] which is a brush that can be retracted into a plastic tube to prevent contamination of bacteria in the throat while inserting and removing the instrument.
The medical history includes obtaining the symptoms of pulmonary TB: productive, prolonged cough of three or more weeks, chest pain, and hemoptysis.Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to purulent. [1]
In a clinical study conducted the sensitivity of the MTB/RIF test on just 1 sputum sample was 92.2% for culture-positive TB; 98.2% for smear+ and culture-positive cases; and 72.5% for smear-negative, culture-positive cases, with a specificity of 99.2%. Sensitivity and higher specificity were slightly higher when 3 samples were tested. [10]
Curschmann's spirals are a microscopic finding in the sputum of asthmatics. They are spiral-shaped mucus plugs from subepithelial mucous gland ducts of bronchi. They may occur in several different lung diseases [1] and may refer to parts of the desquamated epithelium seen in lavages from asthmatic patients. [2]
A small intestine sample stained using the Grocott's methenamine silver stain demonstrating histoplasma (black round yeast with narrow budding) in a granuloma. In pathology, the Grocott–Gömöri's methenamine silver stain, abbreviated GMS, is a popular staining method in histology.