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Sputum
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==Description== The best sputum samples contain very little [[saliva]],<ref>[https://www.ncbi.nlm.nih.gov/nlmcatalog/101315566 Clinical Microbiology procedures handbook], American Society for Microbiology 2nd Ed. 2007 update</ref> as saliva contaminates the sample with oral [[bacteria]]. This is especially true for samples for laboratory testing in [[cytology]] or [[microbiology]]. Specimen adequacy is assessed by the laboratory technologists by examining a [[Gram stain]] or cytology stain of the sputum. More than 25 [[Squamous epithelium|squamous epithelial]] cells at low power magnification exam under the microscope strongly suggest salivary contamination.<ref>{{cite journal|last1=Gershman|first1=Neil H.|last2=Liu|first2=Hong|last3=Wong|first3=Hofer H.|last4=Liu|first4=Jane T.|last5=Fahy|first5=John V.|title=Fractional analysis of sequential induced sputum samples during sputum induction: Evidence that different lung compartments are sampled at different time points|journal=Journal of Allergy and Clinical Immunology|date=August 1999|volume=104|issue=2|pages=322β328|doi=10.1016/S0091-6749(99)70374-X|pmid=10452752|doi-access=free}}</ref> Sputum samples have been used to quantify the degree of airway inflammation in human diseases such as asthma. Specifically, this work has demonstrated that a subgroup of severe asthma patients has airway inflammation that is resistant to treatment with corticosteroids.<ref>{{cite journal|last1=Peters|first1=Michael C.|last2=Kerr|first2=Sheena|last3=Dunican|first3=Eleanor M.|last4=Woodruff|first4=Prescott G.|last5=Fajt|first5=Merritt L.|last6=Levy|first6=Bruce D.|last7=Israel|first7=Elliot|last8=Phillips|first8=Brenda R.|last9=Mauger|first9=David T.|last10=Comhair|first10=Suzy A.|last11=Erzurum|first11=Serpil C.|last12=Johansson|first12=Mats W.|last13=Jarjour|first13=Nizar N.|last14=Coverstone|first14=Andrea M.|last15=Castro|first15=Mario|last16=Hastie|first16=Annette T.|last17=Bleecker|first17=Eugene R.|last18=Wenzel|first18=Sally E.|last19=Fahy|first19=John V.|title=Refractory airway type 2 inflammation in a large subgroup of asthmatic patients treated with inhaled corticosteroids|journal=Journal of Allergy and Clinical Immunology|volume=143|issue=1|pages=104β113.e14|date=March 2018|doi=10.1016/j.jaci.2017.12.1009|pmid=29524537|pmc=6128784}}</ref> When a sputum specimen is plated out in microbiology, it is best to get the portion of the sample that almost looks like yellow pus onto the swab. If there is any blood in the sputum, this should also be on the swab.{{citation needed|date=July 2007}} Microbiological sputum samples are used to look for infections, such as ''[[Moraxella catarrhalis]]'', ''[[Mycobacterium tuberculosis]]'', ''[[Streptococcus pneumoniae]]'', and ''[[Haemophilus influenzae]]''. Other [[pathogens]] can also be found. [[wikt:purulent|Purulent]] sputum<ref name="DeGowin's">{{cite book|author=Richard F. LeBlond|author2=Richard L. DeGowin|author3=Donald E. Brown|title=DeGowin's diagnostic examination|location=New York|publisher=McGraw-Hill|date=2004|isbn=0-07-140923-8}}</ref> contains [[pus]], composed of [[Leukocyte|white blood cells]], cellular debris, dead tissue, [[serous fluid]], and viscous liquid ([[mucus]]). Purulent sputum is typically yellow or green. It is seen in cases of pneumonia, [[bronchiectasis]], [[lung abscess]], or an advanced stage of [[bronchitis]].<ref>[https://www.medicalnewstoday.com/articles/318924 What can sputum tell us?]</ref>
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