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.