1. Upper and Lower Respiratory Tract Infection

2. Upper Respiratory Tract Infection “Throat Swab”

3. Throat swap culture First step : Breath deeply.
Second step: open mouth widely& push the tongue out& phonate “AAHHH”

4. Third step: insert the cotton swap through the mouth and rotate on the area of tonsil or both tonsil.

5. 5th step: transport the specimen to the lab as soon (avoid dry)
4th step: remove the cotton swap from the mouth, avoid touch the tongue, teeth…
5th step: transport the specimen to the lab as soon (avoid dry)

6. 6th step
take the swap under sterile condition, rotate it on the first quadrant of blood agar plate

7. 7th step
# 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)

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

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

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

11. Haemophilus influenzae
G-ve, blood lover, fastidious M.O. need:
X factor heme extra & intracellular.
V factor NAD intracellular.
Best media Choclate

12. Haemophilus influenzae
G-negative coccobacilli, typical of H. influenzae
Grayish mucoid colonies of H. influenzae on chocolate agar

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

14. Haemophilus influenzae

15. 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.

16. 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.

17. 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.

18. 3- Material expelled deposited on the swab and cultured in three different media.
* Blood media.
* Chocolate.
* MacConcy.

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

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

21. Microscopic Examination
Mycobacterium tuberculosis
Acid fast bacilli

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

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

24. 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

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

26. IMViC reaction of K. pneumoniae:

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

28. Pseudomonas aeruginosa
Results of oxidase test

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

30. Paragonimus westermani
Adult worm in the lung.
Hermaphrodite (both sex)

31. Paragonimus westermani
Eggs in sputum : diagnostic stages.

32. Paragonimus westermani

33. THANK YOU