In the article, we will consider for what reasons leukocytes in sputum are detected. Sputum is a discharge from the respiratory tract that is pathological in nature and appears as a result of coughing. Expectorant is evidence of impaired functionality of the internal lining of the respiratory tract. Laboratory testing of sputum is widely used for diagnostic purposes in pathologies of the bronchi and lungs.
The results of the procedure make it possible to differentiate diseases that occur accompanied by cough and other typical clinical symptoms. You can collect sputum for subsequent laboratory research on your own or with the help of bronchoscopy - special medical manipulation. What sputum leukocytes are talking about is interesting to many.
The need for sputum testing
The main purpose of this study is to clarify the alleged diagnosis. In healthy people, sputum is not produced.
The progression of pathological processes in the lungs or bronchi leads to changes in the activity of the corresponding structures, accompanied by the development of pain in the chest, shortness of breath, cough. In addition, the amount of mucus produced increases, the addition of bacterial microflora is possible. As a result, the patient develops a cough with sputum production. What do white blood cells mean in this secret, it is important to find out in advance.
Given the proposed diagnosis and the results of visual analysis, the specialist determines the appropriate study. Using a variety of sputum analysis options allows you to evaluate the physico-chemical properties of the fluid, changes in the cytological nature (the presence of cancer cells), bacterial invasion. Very often, white blood cells are found in sputum in large numbers.
Varieties of research
The study of bronchial secretion can be carried out not only using specialized equipment, but also with the naked eye.
Given the pathology that the specialist suspects, the following diagnostic tests can be used:
- General laboratory examination of sputum. The doctor evaluates the physical characteristics of the mucus produced by coughing.
- Microscopic (cytological) examination. To conduct an appropriate diagnosis, the laboratory assistant uses a microscope. By enlarging the image, the liquid is examined. This technique allows you to determine the presence or absence of pathological cells that can appear in the mucus in certain pathologies.
- Chemical. In this case, an assessment is made of the changes occurring in the metabolism of the ciliary epithelium and bronchial alveolocytes.
- Back sowing sputum (bacteriological study). This study is based on sowing bacteria that are obtained from sputum on a nutrient medium. If the colony begins to grow, then this indicates the presence of a pathogen in the respiratory system. An important advantage of sowing is the ability to determine the sensitivity of bacteria to certain antimicrobial medicines in a laboratory setting.
In severe forms of respiratory tract pathologies, for the purpose of timely diagnosis, all research options can be assigned to the patient. Given the results, the specialist selects the necessary therapy. Normal white blood cells in sputum are absent.
General laboratory test
It is worth noting that a macroscopic or general sputum examination allows you to evaluate the mucous secretion immediately after receiving it. This version of the analysis has been used by specialists for many years. Even before the invention of modern analyzers and microscopes, doctors determined the diagnosis based on the appearance of expectorant mucus.
In a diagnostic study, the specialist turns his attention to certain aspects.
number
50-1500 ml of sputum can be excreted per day - it all depends on the underlying disease, which disrupts the normal secretion of goblet cells. Respiratory pathologies such as pneumonia and bronchitis cause the release of about 200 ml of sputum per day. White blood cells are not always present in the analysis.
A sharp increase in this indicator is observed when blood or pus accumulates in the respiratory tract, which then naturally leaves the respiratory tract. So, with bronchiectasis, a drained abscess, lung gangrene, up to one and a half liters of sputum can be released.
What else does sputum testing show? We will talk about leukocytes and other cells in secret below.
Character
By the nature of the liquid expectorated during coughing, pulmonologists classify sputum into the following types:
- Bloody. When portions of blood or individual red blood cells get into the liquid expectorated during a cough, it acquires a characteristic color. Such symptoms indicate vascular damage. Possible causes are actinomycosis, pulmonary infarction, trauma, and cancer.
- Mucous. It is a favorable sign. Pathologies in which mucous sputum is secreted - tracheitis, chronic forms of bronchitis, bronchial asthma.
- Mucopurulent. Indicates an additional accession of a bacterial infection. In addition to cough and sputum, a fluid is released, which is the waste products of pathogenic organisms and bacteria destroyed by immune cells. Likely pathologies are gangrene, bacterial forms of pneumonia, and lung abscess.
- Purulent. It occurs for the same reasons as mucopurulent. The main difference is that it contains a larger number of tissue decay products and pus.
Assessing the nature of the secret allows you to understand the pathological process that develops in the respiratory system, to select adequate therapy, especially if leukocytes are increased in sputum.
Color
Her color changes depending on her character. The following combinations are likely:
- Mucous. May be transparent or have a grayish color.
- Mucopurulent. Has a gray or yellow color, may contain purulent inclusions.
- Purulent. Sputum has a brown, green, dark yellow color.
- Bloody. Includes a variety of shades of red. It should be remembered that a reddish color indicates the presence in the sputum of altered red blood cells. If the vessel is damaged, then sputum becomes pink or scarlet.
Smell
In approximately 75% of cases, sputum has no characteristic odor. The one exception is purulent fluid. This aroma is due to the presence of dead tissue particles in the mucus. In some cases, a fruity odor may be noted - when a cyst breaks into the lung in which the helminth developed (echinococcus).
Layering
The mucous secretion secreted during the cough process has a predominantly homogeneous structure. Sputum, which is divided into layers, indicates the development of the following diseases:
- Abscess of the lung. In this case, sputum is divided into two layers - putrefactive and serous.
- Gangrene of the lung. In this case, the third is added to the first two layers - foamy. Its appearance is due to the activity of certain microorganisms that produce gas bubbles.
Visual analysis of sputum allows you to quickly determine the diagnosis, without conducting additional studies.
Impurities
The following impurities may be contained in the mucous secretion: serous fluid, pus, red blood cells. The presence of these inclusions allows the specialist to determine the degree of damage to the lung tissue, to understand what pathology is primary in each particular clinical case.
Chemical studies of sputum
A chemical study of bronchial secretion allows you to determine how pronounced the pathological process. Based on the results, the doctor selects the appropriate treatment methods to stabilize the functionality of the ciliary epithelium.
Reaction
The normal level of sputum acidity is considered to be pH 7-11. With the progression of the decay of lung tissue, oxidation of the secret occurs. In this case, the acidity index is 6. The reasons for the change in acidity values are based on a disturbed exchange of minerals and salts.
Protein
Protein is almost always present in secreted sputum. Normally, its rate is 0.3%. A slight increase in this indicator (up to 1-2%) may indicate the progression of tuberculosis. A significant increase - up to 10-20% - is a sign of the formation of croupous pneumonia. Laboratory analysis of sputum with determination of protein concentration allows us to distinguish these diseases against the background of the study of the clinical picture (chest pain, shortness of breath, cough) and the results of other diagnostic studies. What is the norm of white blood cells in sputum analysis, patients often ask. About it further.
Bile pigments
Bile pigments (microparticles of cholesterol) can be excreted in sputum if the following pathologies are present:
- Malignant neoplasms of the respiratory tract.
- Enterococcal cyst.
- Abscess.
Microscopic examination
Microscopic examination of bronchial secretion allows you to determine the presence of microorganisms or cells (which should normally be absent) using an optical apparatus.
Epithelial cells
The presence of epithelial cells in sputum is a normal variant. During a microscopic examination, a specialist draws attention to a sharp increase in the number of cells, the appearance of epithelial cylinders. This picture indicates damage to the respiratory tract and its internal membranes.
Alveolar macrophages
The main function of these cells is to provide local immunity. Sputum may contain a small amount of alveolar macrophages. With a sharp increase in their concentration, one can judge the presence of chronic forms of inflammatory processes (tracheitis, asthma, bronchiectasis, bronchitis).
White blood cells in sputum
This indicator is very informative. Normal white blood cells in sputum should be absent. Moreover, this rule is equivalent for men and women. The presence of leukocytes in sputum indicates the presence of an acute inflammatory process, which can develop against a background of bacterial infection. This means that the following pathologies can be present in the body: bronchiectasis, pneumonia, abscess. The doctor selects the treatment methods depending on which particular disease provoked the increased white blood cells in the sputum.
Let's consider this question in more detail.
In practice, normal leukocytes in sputum in women and men contain from 2 to 5 units. These are mainly neutrophils, but there may be other varieties of white blood cells. What does it mean if white blood cells in sputum in women and men deviate from the norm? It depends on what kind of species are defined there.
The aforementioned neutrophils are present in the analysis if a person has some kind of bacterial infection of the respiratory system: bronchitis, pneumonia, etc. Eosinophils can also be found in mucus. They are a sign of allergic diseases: pollen allergies, bronchial asthma, even helminth infections. Sometimes lymphocytes are found in sputum, and this indicates a possible human disease with whooping cough, tuberculosis.
For example, 30 leukocytes were found in sputum. This may indicate acute bronchitis. At the same time, the secret is light in color and in addition to white blood cells, macrophages, coccal flora in large quantities, a slight admixture of red blood cells can be observed in it.
20 leukocytes in sputum can appear with bronchiectasis or also with acute bronchitis. Diagnosis is based on other indicators.
Red blood cells
Red blood cells in sputum are detected if ruptures of large or small vessels occur. The specialist determines the nature of the bleeding by the concentration of these bodies. It is worth noting separately the appearance in the bronchial secretion of modified red blood cells penetrating through the dilated vascular walls in the absence of rupture of the latter. A typical example of pathology is croupous pneumonia.
Elastic fibers
The presence of such fibers in the mucous secretion indicates a serious lung lesion, accompanied by tissue breakdown. The main examples of such pathologies are: tuberculosis, late stages of bronchiectatic disease, gangrene, cancer, accompanied by destructive lesions of the organ parenchyma.
Tumor cells
The appearance of atypical cells in bronchial secretion indicates a developing oncological process. To clarify the localization and type of pathology, it is necessary to conduct additional research.
It should be noted that with the help of microscopic examination, cell differentiation can also be established. The less modified the cells are similar to the original, the worse the prognosis of the pathology.
Detection of tuberculous mycobacteria
What do leukocytes in sputum mean now is known. Microbiological examination of the secret is one of the most important methods for verification of tuberculosis. The causative agent of pathology is Koch's wand.
The presence of a microorganism is determined using a microscope. In order to visualize the pathogen, the biomaterial should be stained according to the Ziehl-Nielsen method. When a Koch bacillus is found in sputum, a specialist in the results of the analysis indicates CD (+). This suggests that the pathogen was detected in the fluid. Such patients should be isolated. If the result is CD (-), then this means that the patient does not spread the bacterium.
Back sowing for infectious lung pathologies
Bacteriological examination of sputum in inflammatory lesions of the respiratory tract is mainly used to verify community-acquired infections (actinomycosis, pneumonia and others).
A bacteriological study is carried out in three stages:
- The intake of bronchial mucus for analysis.
- Sowing sputum on a nutrient medium that has undergone preliminary preparation.
- Reseeding the required colony, the study of the physical, chemical characteristics of the pathogen.
If necessary, the susceptibility of microorganisms to antimicrobial medicines is established by an additional sensitivity test. For this, paper circles are placed in a Petri dish that are treated with antibiotic agents. Those drugs around which the maximum destruction of the colony occurred are recommended for use in the treatment of a particular patient.
Indications for general laboratory tests
The doctor can recommend a general laboratory study of bronchial secretion in almost any pathology that is accompanied by coughing and expectoration of sputum. But this diagnostic study is rarely used for seasonal viral infections. In such cases, regression of cough and other symptoms is observed when the patient observes bed rest and drink plenty of water.
Sputum examination is required if you suspect the development of the following pathologies:
- Pneumoconioses are professional pathologies of the bronchopulmonary system.
- Chronic forms of bronchitis.
- Bronchial asthma.
- Gangrene of the lung.
- Malignant neoplasms.
- Abscess of the lung.
- Tuberculosis.
Confirmation of the proposed diagnosis is carried out using instrumental, physical, laboratory methods.
Study preparation
The process of preparing the patient for the collection of bronchial secretions for the study is very responsible, the quality of the study may depend on it. If you ignore simple recommendations, additional impurities may appear in the mucus, which will prevent the laboratory assistant from identifying the root causes of the development of cough and bronchopulmonary pathology.
Recommendations:
- Capacity preparation. The best option is to use containers sold in pharmacies. If such a container is not available, you can use a half-liter can or a small plastic tank. But it is important to take into account that such a container is very inconvenient and can be used only in atypical circumstances, if it is not possible to use a normal container.
- A couple of hours before sputum collection, the patient should brush his teeth and rinse his mouth. Removing saliva and food particles can improve the accuracy of a diagnostic study.
- Get medical advice. The specialist will tell you in detail how to properly collect the bronchial secretion for the study.
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Which means: “White blood cells in sputum are elevated,” the doctor will tell. Decryption of the analysis is carried out by a TB specialist or pulmonologist. The following indicators are normal:
- Quantity - 10-100 ml.
- Color is missing.
- The smell is absent.
- Lamination - absent.
- Acidity is neutral or alkaline.
- The character is mucous.
- Impurities are absent.
After examining the mucus, the laboratory assistant fills in a special form, in which he makes certain indicators. If a microscopic examination is carried out, the number of cells contained in the mucus is entered in special columns. Sometimes there are many white blood cells in sputum, as well as red blood cells, macrophages.
Thus, the study of the secretion released during coughing is an effective diagnostic method, which allows to identify pathological changes in the respiratory system and to prescribe adequate therapy in time.
We examined what large numbers of white blood cells in sputum mean.