Case 71. Panel: Bacteria seen in sputum preparations
　 　 　 　 　
　 　 S. pneumoniae, MRSA, B. catarrhalis, H. influenzae, B. pertussis, K. pneumoniae, P. aeruginosa, M. tuberculosis, L. pneumophila 　 　
　 　 　 　 　
　 　
Key words : Gram stain, Ziehl-Neelsen stain, Gimenez stain, sputum
 　 　
　 　 　
　
　 　 　
Panel 1: Bacteria seen in sputum preparations
Streptococcus pneumoniae (Gram).　Gram-positive diplococci with capsule (haloe) formation, located outside neutrophils.		 　 Panel 2: Bacteria seen in sputum preparations
Methicillin-resistant Staphylococcus aureus (MRSA) (Gram).　Irregularly clustered Gram-positive cocci in and outside neutrophils.
　 　 　
　
　 　 　
Panel 3: Bacteria seen in sputum preparations
Branhamella (Moraxella) catarrhalis (Gram).　Gram-negative diplococci phagocytized by neutrophils.		 　 Panel 4: Bacteria seen in sputum preparations
Haemophilus influenzae (Gram).　Small-sized, Gram-negative short rods mainly seen outside neutrophils.
　 　 　
　
　 　 　
Panel 5: Bacteria seen in sputum preparations
Bordetella pertussis (Gram).　Small-sized, Gram-negative short rods mainly seen outside neutrophils, resembling H. influenzae.		 　 Panel 6: Bacteria seen in sputum preparations
Klebsiella pneumoniae (Gram).　Large-sized, Gram-negative rods with capsule formation.
　 　 　
　
　 　 　
Panel 7: Bacteria seen in sputum preparations
Pseudomonas aeruginosa (mucoid type, Gram).　Gram-negative rods floating within mucoid matrices.		 　 Panel 8: Bacteria seen in sputum preparations
Pseudomonas aeruginosa (mucoid type, colloidal iron).　The mucoid matrix of P. aeruginosa is positively stained with colloidal iron.
　 　 　
　
　 　 　
Panel 9: Bacteria seen in sputum preparations
Mycobacterium tuberculosis (Ziehl-Neelsen).　A few large-sized rods stained red by carbol fuchsin solution are phagocytized by macrophages.		 　 Panel 10: Bacteria seen in sputum preparations
Legionella pneumophila (Gimenez).　Red-stained rods are seen in the cytoplasm of macrophages. Gimenez stain is not specific for Legionella, and a variety of microbes such as H. pylori and rickettsia, are identified with this stain.