In the article, we will consider the reasons why leukocytes are found in sputum. Sputum is a discharge from the respiratory tract that is pathological in nature and appears as a result of coughing. Expectoration is evidence of a violation of the functionality of the internal lining of the respiratory tract. Laboratory examination 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 are accompanied by cough and other typical clinical symptoms. You can collect sputum for subsequent laboratory testing on your own or with the help of bronchoscopy - a special medical manipulation. What white blood cells in sputum say is interesting to many.
Need for sputum examination
The main purpose of this study is to clarify the alleged diagnosis. In he althy people, sputum is notproduced.
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 chest pain, 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 the leukocytes in this secret mean is important to find out in advance.
Given the alleged diagnosis and the results of visual analysis, the specialist determines the appropriate study. The use of various options for sputum analysis makes it possible to assess the physicochemical properties of the fluid, changes in the cytological nature (presence of cancer cells), and bacterial invasion. Very often, leukocytes are found in sputum in large numbers.
Varieties of research
Research of bronchial secretions can be carried out not only with the use of specialized equipment, but also with the naked eye.
Based on the pathology suspected by the specialist, the following diagnostic tests may be used:
- General laboratory sputum examination. The doctor evaluates the physical characteristics of the mucus produced by the cough.
- Microscopic (cytological) examination. To conduct the appropriate diagnosis, the laboratory assistant uses a microscope. By enlarging the image, the study of the liquid is carried out. This technique allows you to determine the presence or absence of pathological cells,capable of appearing in mucus in certain pathologies.
- Chemical. In this case, an assessment is made of changes occurring in the metabolism of the ciliated epithelium and bronchial alveolocytes.
- Sputum culture (bacteriological examination). This study is based on the sowing of bacteria, which 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 culture is the ability to determine the sensitivity of bacteria to certain antimicrobial drugs in the laboratory.
In severe forms of pathologies of the respiratory tract, for the purpose of timely diagnosis, the patient can be assigned all options for research. Based on the results obtained, the specialist selects the necessary therapy. Normally, leukocytes are absent in sputum.
General Lab Study
It is worth noting that macroscopic or general examination of sputum 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 expectorated mucus.
During a diagnostic examination, the specialist pays attention to certain aspects.
Quantity
50-1500 ml of sputum can be secreted per day - it all depends on the underlying disease, which disrupts the normal secretion of goblet cells. Respiratory pathologies likepneumonia and bronchitis cause about 200 ml of sputum per day. Leukocytes 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 leave the respiratory tract. So, with bronchiectasis, a drained abscess, gangrene of the lung, up to one and a half liters of sputum can be secreted.
What else does the sputum test show? Let's talk about white blood cells and other cells in secret below.
Character
According to the nature of the coughing fluid, pulmonologists classify sputum into the following types:
- Bloody. When portions of blood or individual erythrocytes enter the liquid, expectorated during the cough, it acquires a characteristic color. These symptoms indicate vascular damage. Probable causes are actinomycosis, pulmonary infarction, trauma, cancer.
- Mucoid. It is a favorable sign. Pathologies in which mucous sputum is secreted - tracheitis, chronic forms of bronchitis, bronchial asthma.
- Mucopurulent. Indicates an additional attachment of a bacterial infection. In addition to coughing and sputum, there is a release of fluid, which is the waste products of pathogenic organisms and bacteria destroyed by immune cells. Probable pathologies are gangrene, bacterial forms of pneumonia, lung abscess.
- Purulent. Occurs for the same reasons as mucopurulent. The main difference is that it contains more tissue productsdecay and pus.
Assessment of 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 elevated in the sputum.
Color
The color of her changes depending on her character. Possible combinations are:
- Mucoid. May be transparent or greyish.
- Mucopurulent. Has a gray or yellow color, may contain purulent inclusions.
- Purulent. Sputum is brown, green, dark yellow.
- Bloody. Includes various shades of red. It should be remembered that a reddish color indicates the presence of mutated red blood cells in the sputum. If the vessel is damaged, the sputum becomes pink or scarlet.
Smell
In about 75% of cases, sputum has no characteristic odor. The only exception is purulent fluid. This aroma is due to the presence of dead tissue particles in the mucus. In some cases, a fruity smell may be noted - when a cyst erupts in the lung, in which a helminth (echinococcus) has developed.
Layer
The mucous secretion secreted during the coughing process has a predominantly homogeneous structure. Sputum that separates 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. His appearancedue to the vital activity of certain microorganisms that emit gas bubbles.
Visual sputum analysis allows you to quickly determine the diagnosis without additional research.
Impurities
Mucous secretion may contain the following impurities: serous fluid, pus, red blood cells. The presence of these inclusions allows the specialist to determine the degree of lung tissue damage, to understand which pathology is primary in each specific clinical case.
Sputum chemistry
Chemical examination of bronchial secretions allows you to determine how pronounced the pathological process is. Taking into account the results obtained, the doctor selects the appropriate treatment methods to stabilize the functionality of the ciliated epithelium.
Reaction
The normal level of sputum acidity is pH 7-11. With the progression of the process of disintegration 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 the disturbed metabolism of minerals and s alts.
Protein
Protein is almost always present in 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 lobar pneumonia. Laboratory analysis of sputum with the determination of protein concentration makes it possible to distinguish these diseases against the background of the study of the clinical picture (pain inchest, shortness of breath, cough) and the results of other diagnostic studies. What is the rate of leukocytes in sputum analysis, patients often ask. More on that later.
Bile pigments
Bile pigments (cholesterol microparticles) can be secreted into sputum if the following pathologies are present:
- Malignant neoplasms of the respiratory tract.
- Enterococcal cyst.
- Abscess.
Microscopic examination
Microscopic examination of bronchial secretions allows you to determine the presence of microorganisms or cells (which should normally be absent) using an optical apparatus.
Epithelial cells
Presence of epithelial cells in sputum is a normal variant. In the course of microscopic examination, the specialist draws attention to a sharp increase in the number of cells, the appearance of epithelial cylinders. This picture indicates damage to the airway and its inner 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).
Leukocytes in sputum
This indicator is very informative. Normally, leukocytes in the sputum should be absent. Moreover, this rule is equivalent for men andwomen. The presence of leukocytes in sputum indicates the presence of an acute inflammatory process that can develop against the background of bacterial infection. This means that the following pathologies may be present in the body: bronchiectasis, pneumonia, abscess. The doctor selects the methods of treatment depending on what kind of disease provoked increased leukocytes in the sputum.
Let's consider this issue 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 types of white blood cells. What does it mean if leukocytes in sputum have deviated from the norm in women and men? It depends on what types of them are defined there.
The above-mentioned 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 the mucus. They are a sign of allergic diseases: allergies to pollen, bronchial asthma, even helminth infections. Sometimes lymphocytes are found in the 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 leukocytes, macrophages, and coccal flora in large quantities, it may contain a slight admixture of erythrocytes.
20 leukocytes in sputum can appear in bronchiectasis or also in acute bronchitis. The diagnosis is madebased on other indicators.
Erythrocytes
Erythrocytes in sputum are detected if there are ruptures of large or small vessels. The specialist determines the nature of bleeding by the concentration of these bodies. It is worth noting separately the appearance in the bronchial secretion of modified erythrocytes 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 injury, accompanied by tissue breakdown. The main examples of such pathologies are: tuberculosis, late stages of bronchiectasis, 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 studies.
It is worth noting that with the help of microscopic examination, cell differentiation can also be established. The less the altered cells are similar to the original, the worse the prognosis of the pathology.
Detection of tuberculosis mycobacteria
What leukocytes in sputum mean is now known. Microbiological examination of the secret is one of the most important methods for verifying tuberculosis. The causative agent of the pathology is Koch's wand.
The presence of a microorganism is determined using a microscope. With the aim ofFor visualization of the pathogen, the biomaterial should be stained according to the Ziehl-Neelsen method. When Koch's bacillus is found in sputum, the specialist indicates BK (+) in the results of the analysis. This suggests that the pathogen was identified in the liquid. Such patients should be isolated. If the result is BC (-), then this means that the patient does not spread the bacteria.
Bacterial culture for infectious pathologies of the lungs
Bacteriological examination of sputum in inflammatory lesions of the respiratory tract is mainly used to verify community-acquired infections (actinomycosis, pneumonia, etc.).
Bacteriological examination is carried out in three stages:
- Sampling of bronchial mucus for analysis.
- Sputum culture on pre-prepared nutrient medium.
- Reseeding the desired colony, studying the physical, chemical characteristics of the pathogen.
If necessary, the susceptibility of microorganisms to antimicrobial drugs is established by additional sensitivity testing. To do this, circles of paper are placed in a Petri dish, which 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 testing
The doctor may recommend a general laboratory examination of bronchial secretions in almost any pathology that is accompanied by cough andexpectoration of sputum. But this diagnostic study is rarely used for viral seasonal infections. In such cases, regression of cough and other symptoms is noted when the patient is in bed and drinking plenty of fluids.
Sputum examination is required if the following pathologies are suspected:
- Pneumoconiosis is an occupational pathology of the bronchopulmonary system.
- Chronic forms of bronchitis.
- Asthma.
- Gangrene of the lung.
- Malignant neoplasms.
- Lung abscess.
- Tuberculosis.
Confirmation of the alleged diagnosis is carried out using instrumental, physical, laboratory methods.
Preparing for the study
The process of preparing a patient for the collection of bronchial secretions for examination is very responsible, the quality of the examination may depend on it. If simple recommendations are ignored, additional impurities may appear in the mucus that will prevent the laboratory assistant from determining the root causes of the development of cough and bronchopulmonary pathology.
Recommendations:
- Preparing the container. The best option is to use containers sold in pharmacies. If there is no such container, you can use a half-liter jar or a small plastic tank. But it is important to take into account that such packaging is very inconvenient and can only be used in atypical circumstances, if it is not possible to use a normal container.
- A couple of hours before sputum collection, the patient should cleanteeth, rinse the mouth. Removal of saliva and food particles improves diagnostic accuracy.
- Get medical advice. The specialist will tell you in detail how to properly collect bronchial secretions for research.
When a patient is giving sputum for the first time, it often takes several tries to get it right.
Biomaterial donation
In addition to the nuances described above, it should be noted that it is recommended to collect bronchial mucus in the morning. The main reason for this recommendation is that quite a lot of secretion accumulates in the bronchi from the night, which greatly facilitates its expectoration. It is possible to collect sputum at other times of the day, but it must be taken into account that the quality and quantity of the studied biomaterial will decrease.
When collecting slime, you should follow the following algorithm:
- Take a deep breath, hold for 10 seconds.
- Exhale smoothly.
- Retake 2 breaths.
- On the third exhalation, push the air out of the chest with force and cough.
- Bring the container to your lips, spit out the mucus.
If you follow this algorithm, you can collect enough bronchial mucus for research. If difficulties arise, you can lie on your side, lean forward slightly. To speed up sputum discharge, you can additionally carry out steam inhalation or use a mucolytic drug.
Collecting bronchial secretions in this way is notexcludes that saliva will get into the test sample. An alternative to this is bronchoscopy. During the procedure, the doctor uses an endoscope to examine the condition of the ciliated epithelium and collect the required amount of mucus for analysis.
Sputum collection at home
Collecting material for research can be done at home, following the above algorithm. It is important to close the container tightly after the mucus has been placed in it. In addition, the sample should be delivered to the laboratory as soon as possible. Otherwise, the information content of the analysis may decrease.
Specialists note that in about half of cases, patients, collecting sputum at home, violate the established rules. In this regard, there is a need to retake tests.
Research transcript, normal readings
What does it mean: "Leukocytes in sputum are increased," the doctor will tell. The interpretation of the analysis is carried out by a phthisiatrician or pulmonologist. The following indicators are normal:
- Quantity - 10-100 ml.
- Color - none.
- Smell - none.
- Lamination – none.
- Acidity - neutral or alkaline.
- Character is slimy.
- Impurities - none.
After examining the mucus, the laboratory assistant fills out a special form, in which he enters certain indicators. If a microscopic examination is carried out, the number of cells contained in the mucus is entered into special columns. Sometimes there are many leukocytesin sputum, as well as erythrocytes, macrophages.
Thus, the study of cough secretions is an effective diagnostic method that allows you to identify pathological changes in the respiratory system and prescribe adequate therapy in time.
We looked at what white blood cells in sputum mean in large numbers.
