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Chapter 6 : Sputum, Aspirates, and Biopsy Material

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Abstract:

  • Expectorated sputum
  • Induced sputum
  • Aspirates
    • Lungs and liver
    • Lymph nodes, spleen, liver, bone marrow, spinal fluid, eyes, and nasopharynx
    • Cutaneous ulcer
  • Biopsy material
    • Skin
    • Lymph nodes
    • Muscle
    • Rectum and bladder

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Figures

Image of Figure 6.1
Figure 6.1

spp. eggs. (Left) Operculated eggs in a sputum specimen. (Right) Eggs photographed at a higher magnification. doi:10.1128/9781555819002.ch6.f1

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.2
Figure 6.2

(Upper) containing ingested polymorphonuclear leukocytes (PMNs) within large vacuoles. (Lower) containing ingested red blood cells (RBCs). Note: the nuclear characteristics are very similar; however, the vacuole sizes are quite different (large vacuoles contain ingested PMNs, small vacuoles contain ingested RBCs). doi:10.1128/9781555819002.ch6.f2

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.3
Figure 6.3

(Left) from the mouth (stained with Giemsa stain). (Right) from a genital specimen (stained with Giemsa stain). Note the large nucleus in and the fact that this flagellate is somewhat smaller than doi:10.1128/9781555819002.ch6.f3

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.4
Figure 6.4

(Upper) . Note that the “parentheses” are visible within the cell wall (methenamine silver stain). (Middle) Microsporidial spores in a stool specimen stained with silver stain (methenamine silver stain). Note the spore with a polar tubule (horizontal line through the spore) within the black box; there are other examples of spores containing the polar tubule throughout the image. (Bottom) Microsporidian spores within an ocular biopsy specimen (methenamine silver stain). In this image the spores are clustered together and polar tubules are not visible. doi:10.1128/9781555819002.ch6.f4

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.5
Figure 6.5

trophozoites within the cyst wall (stained with Giemsa stain). Note that the cyst wall is not visible when Giemsa stain is used. Other trophozoites can also be seen in the background. doi:10.1128/9781555819002.ch6.f5

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.6
Figure 6.6

containing ingested red blood cells within the cytoplasm; morphologically this organism is , and this would be the species designation if organisms were isolated from liver abscess material (trichrome stain). doi:10.1128/9781555819002.ch6.f6

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.7
Figure 6.7

(Upper) Liver abscess caused by Amebae would be found at the advancing margin of the lesion; the last portion of the aspirated material might reveal the organisms. (Illustration by Sharon Belkin.) (Lower) Amebic abscess; note the “flask”-shaped ulcer. doi:10.1128/9781555819002.ch6.f7

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.8
Figure 6.8

Hydatid disease (). (Upper left) Hydatid cyst with protoscolices budding off from the germinal layer. (Upper right) Immature protoscolices, with the dark area being the hooklets. (Lower left) Higher magnification of the protoscolices taken from the hydatid cyst fluid. (Lower right) Hooklets from disintegrating protoscolices. Reprinted from . doi:10.1128/9781555819002.ch6.f8

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.9
Figure 6.9

Hydatid disease (). (Upper) Hydatid protoscolex revealed by Ryan modified trichrome stain. (Lower) Hydatid hooklets revealed by Ryan blue modified trichrome stain (reprinted from ). doi:10.1128/9781555819002.ch6.f9

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.10
Figure 6.10

Note the large karyosome and lobate pseudopodia. Spinal fluid should be examined on a slide, not in a counting chamber, where protozoan trophozoites could mimic white blood cells. (Armed Forces Institute of Pathology photograph.) doi:10.1128/9781555819002.ch6.f10

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.11
Figure 6.11

cyst. Note the fluorescence of the cyst wall. Trophozoites do not fluoresce when calcofluor white is used. doi:10.1128/9781555819002.ch6.f11

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.12
Figure 6.12

Microsporidial spores. (Upper left) Spores in a corneal scraping specimen; (upper right) spores in a fecal specimen (both images stained with silver stain). (Lower left) Microsporidial spores in a urine sediment; (lower right) spores from nasopharyngeal aspirate (both images stained using calcofluor white). doi:10.1128/9781555819002.ch6.f12

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.13
Figure 6.13

Proper way to aspirate material from below the ulcer bed ( spp.); sterile saline (0.5 to 1.0 ml) can be injected under the ulcer prior to aspiration. (Illustration by Sharon Belkin.) doi:10.1128/9781555819002.ch6.f13

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.14
Figure 6.14

cutaneous lesions. doi:10.1128/9781555819002.ch6.f14

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.15
Figure 6.15

(Upper) amastigotes in a cell; the one on the right is stained with Giemsa stain. (Lower left) amastigote; note the nucleus and bar (primitive flagella). (Lower right) spp. oocysts stained with modified acid-fast stain. Note that the sporozoites are visible within some of the oocysts. doi:10.1128/9781555819002.ch6.f15

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.16
Figure 6.16

mites from skin scrapings. (Upper) Note the two mites to the left of center. (Lower) Note the two eggs, the small nymph, and the adult mite (photographed at a higher magnification). If the light is too strong when examining the scrapings in saline, the mites will probably not be seen. doi:10.1128/9781555819002.ch6.f16

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.17
Figure 6.17

culture sediment. Note the promastigotes from the culture sediment. The typical “rosette” formation in the right image is frequently seen. doi:10.1128/9781555819002.ch6.f17

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.18
Figure 6.18

Microfilariae (Giemsa stain). (Upper) In this image, the microfilariae from a skin snip saline preparation are visible after staining. (Lower) Microfilariae from blood; note that the characteristic nuclei are more easily seen in this preparation. doi:10.1128/9781555819002.ch6.f18

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.19
Figure 6.19

spp. larvae in a squash preparation of muscle biopsy tissue; note the encysted larvae. doi:10.1128/9781555819002.ch6.f19

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Image of Figure 6.20
Figure 6.20

eggs seen in a squash preparation of a bladder biopsy specimen. Note the pointed terminal spine. (Armed Forces Institute of Pathology photograph.) doi:10.1128/9781555819002.ch6.f20

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6
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Tables

Generic image for table
TABLE 6.1

Examination of impression smears

Citation: Garcia L. 2016. Sputum, Aspirates, and Biopsy Material, p 107-128. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch6

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