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Caring doc
Caring doc, Doctor
Category: Medical
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Experience:  Internal Medicine Specialist. MBBS,MD
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What does it mean when your sputum gram stain smear shows

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What does it mean when your sputum gram stain smear shows rare epithelial cell, moderate gram positive cocci-pairs and clusters,many grampositive cocci-pairs or chains,rare gram positive bacilli, and moderate leukocytes. The AFB stain showed NO ACID FAST BACILLI SEEN

This report has to be read with caution. Gram staining of the bacteria only allows broad classification of bacterial organisms which then requires further biochemical and microscopic tests to exactly identify the organism.

1. Rare epithelial cells: means there are occasional cells of respiratory epithelium in the sputum. Unless those cells are atypical , it has no significance.

2. Gram positive organisms may be rod shaped --> bacilli or rounded --> cocci

2a. cocci if in clusters may be Staphylococci

2b. if in chains could one of the Streptococci. If in pairs could be streptococcus pneumonaei.

3. Gram positive bacilli: could be any of listeria, corynebacterium , bacillus

4. Leukocytes in the smear may be indicative of inflammatory reaction going on.

From the smear alone it would be very difficult to pinpoint the causative organism .

To be exact you would require Culture and sensitivity testing of the sputum sample.

Most probably you are suffering from respiratory tract infection but the cause needs further testing.

Absence of Acid Fast Bacilli makes Tuberculosis unlikely but for that there should be at least three negative sputum smears.

You could follow the link below to see the classification of gram positive organisms:


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