[Microbiology] Atlas of Upper and Lower Respiratory Tract Infections

Atlas of Upper and Lower Respiratory Tract Infections in microbiology,Upper and Lower Respiratory Tract Infections, atlas in medical, tuyenlab.net

Fig 1. Anatomy of the respiratory tract.

Fig 2. Specimen collection from the throat.

Fig 3. omputed tomography of the paranasal sinuses in a patient with normal
maxillary sinuses (A) and in a patient with bilateral maxillary sinusitis (B). A, The large
(black) cavities on either side of the nasopharynx are the normal maxillary sinuses. Of
note is the absence of thickening of the lining and the absence of any opacity within the
cavity of the maxillary sinuses. B, The difference in the maxillary sinuses compared with
image A is the presence of opacification in both maxillary sinuses. This opacification
represents pus within the sinuses. The maxillary sinus on the right side of the figure
also demonstrates an air-fluid level (the relatively straight, horizontal line between the
air-filled black space above and the gray, fluid-filled space below [arrow]) that is
characteristic of acute, purulent sinusitis.

Fig 4. Gram-stained smear of sputum/exudate with
Haemophilus organisms (arrow).

Fig 5. Gram-stained smear of Legionella species
taken from culture.

Fig 6. Chest radiographs before (A) and after (B) development of an acute,
community-acquired, pneumococcal pneumonia. The patient is facing toward the reader.
B, Consolidation of the right upper lobe of the lung is evidenced by the dense,
whitish opacification of this lobe, which contrasts with the normal air (black) density
of the remainder of the lung.

Fig 7. Gram-stained smear of Streptococcus
pneumoniae isolated from the blood culture of a patient
with pneumococcal pneumonia.

Fig 8. Gram stain of gram-negative bacilli in
tracheal aspirate (arrow indicates intracellular gram-negative
bacillus). They are common pathogens in nosocomial
pneumonia.

Fig 9. Gram-stained smear of sputum that is
acceptable for culture, with white blood cells and
gram-positive diplococci.

Fig 10. A, Expectorated sputum: smear and Gram stain visualized with light
microscopy under low-power view (LPV). There is no presence of pus cells. It shows heavy
presence of contaminating bacteria and epithelial cells. The sample is saliva, not sputum.
There could be several reasons for submission of this sample to the laboratory. The
patient could have been poorly directed and simply “spit” into the collection container,
or the patient’s cough may not be productive of sputum. B, Aspirated sputum: smear
and Gram stain visualized with light microscopy under high-power view (HPV). There is
no presence of pus cells or organisms. However, it shows specialized cells and mucus
(pink-stained background) that are the local materials from the surface of the
tracheobronchial tree. This smear confirms that sputum was sampled and that there is no
suspicion for infection and no evidence of significant contamination (e.g., large numbers
of epithelial cells, commonly found in the mouth). Routine bacterial culture of this
specimen might still grow insignificant oral flora or pathogens.

Fig 11. Lung exudate from a patient with hematologic disorder showing alveoli
containing branching fungal elements. A, Hematoxylin and eosin stain; B, Gomori
methylene silver (GMS) stain.

Fig 12. Acid-fast bacillus stain of sputum containing
mycobacteria (red-stained organisms) (arrow).

Fig 13. Gomori methylene silver (GMS) stain of
bronchoalveolar lavage with P. jiroveci (carinii) cysts.

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