1. Upper and Lower Respiratory Tract Infection

2. Infections of the Respiratory tract
Most common entry point for infections
Upper respiratory tract
nose, nasal cavity, sinuses, mouth, throat
Lower respiratory tract
Trachea, bronchi, bronchioles, and alveoli in the lungs

4. Throat swab culture
A plain cotton wool swab should be used to collect as much exudates as possible for tonsils, posterior pharyngeal wall and other area that is inflamed.

5. To contributes better results
If cooperated by patient, the swab should be rubbed with rotation over one tonsillar area of the soft palate, uvula, the other tonsillar area and finally the posterior pharynx.

6. Good lighting conditions should be ensured and use of a disposable wooden spatula or tongue depressor to pull outwards and so depress the tongue.

7. The swab should be replaced in its tube with care not to soil the rim.
If it cannot be transported it should be placed in refrigerator at 4C until delivery to lab.

8. take the swab under sterile condition, rotate it on the first quadrant of blood agar plate

9. then do the streaking method by loop and stab it few times, then incubate at 37 c / 24 h.
Search for hemolytic
ß hemolytic: Clear zone.
Streptolysin S
Streptolysin O (v. imp)

10. Streptococcus pyogenes
Colonies of Streptococcus pyogenes on sheep blood agar.
Notice: * Presence of beta hemolysis around colonies
* Enhanced hemolysis around stabbing sites
* Sensitivity to bacitracin (Disk A)

11. Streptococcus pyogenes
Pin point colony: (white or gray)
Gram stain: G+ve, cocci, single chain.
Catalase enzyme: differentiate between
Streptococcus –ve
Staphylococcus +ve

12. Streptococcus pyogenes
Antibiotic susceptibility of S. pyogenes.
Bacitracin Sensitive
Optochin Resistance

13. Haemophilus influenzae
Facultative anaerobic, Gram-negative coccobacilli
small short-rod, pleomorphism,
nonmotile

14. “ Blood-loving ” 35- 370C, 5-10% CO2
X-factor : heat-stable substance ; Hemin or Hematin .
V-factor : heat-labile vitamin-like substance.
Both X and V factors are found within RBCs.

15. “ Blood-loving ” BA CA X-factor Heating X, V-factors Release V-factor
inactivate NADase
X, V-factors

16. Haemophilus influenzae
G-negative coccobacilli, Grayish mucoid colonies on chocolate agar

17. Haemophilus influenzae
Shows phenomena Satellitism: growth on blood agar near a line of Staphylococcus aureus.

19. Haemophilus influenzae

20. Corynebacterium diphtheriae
G+ve non motile, pleomorphic rod.
Formation of pseudomembrane covering the mouth & pharynx.
Can be severe and sometimes fatal disease.

21. Lower Respiratory Tract Infections
Sputum Examination:
Sputum: Trachiobroncial secretions, visco-elastic (95% water and only 5% solids) as it comes out, it is contaminated by nasal and salivary secretions and normal bacterial flora of the oral cavity.

22. Specimen collection In case of Adult:
1- mouth should be pre-rinsedremove contaminants.
2- first morning specimen, Good specimen <10 epith and >25 WBCs.

23. In case of children Nasopharyngeal swab. Cough Swab method.
1- the child mouth is held open by using tongue depressor.
2- Epiglottis is visualized and is touched with swab to induce cough.

24. 3- Material expelled deposited on the swab and cultured in three different media.
* Blood media.
* Chocolate.
* MacConcy.

25. Macroscopic Examination
Consistency and Appearance.
normal sputum is clear and watery.
Color of Sputum:
Normal color is clear and colorless.in case of infections

26. Color of Sputum
yellow (indicates pus and epithelial cells)=pneumonic+
Staphylococcus aureus.
 Green (pseudomonas)== Otitis.
 Red (blood) TB.

27. Microscopic Examination
Mycobacterium tuberculosis
Acid fast bacilli

28. Mycobacterium tuberculosis
Culture on Lowenestein-Jensen media.
Yellowish colony on green background

29. Streptococcus pneumoniae
Lancet-shaped,
G-positive diplococci,
typical of S. pneumoniae

30. a hemolysis on 5% sheep blood agar,
S. pneumoniae
a hemolysis on 5% sheep blood agar,
typical of S. pneumoniae. Sensitivity to optochin is also demonstrated

31. Klebsiella pneumoniae
Colonies of Klebsiella pneumoniae on MacConkey agar,
showing lactose fermentation and mucoid appearance

32. IMViC reaction of K. pneumoniae:

33. Pseudomonas aeruginosa
Greenish discoloration of media due to production of pyocyanin by Pseudomonas aeruginosa

34. Pseudomonas aeruginosa
Results of oxidase test

35. Paragonimus westermani
This lung fluke causes Paragonimiasis.
Adult resembles coffee beans
Definitive Host
Any animal that eats crustaceans
Intermediate Host
1st = Snail
2nd = Crustaceans (ex. Crabs)

36. Paragonimus westermani
Life Cycle

37. Paragonimus westermani
Egg
Adult

38. Paragonimus westermani
Metacercaria
Cyst in Lung

39. THANK YOU