How is sputum analysis used in the diagnosis of bronchiectasis?

Updated: Jul 23, 2019
  • Author: Ethan E Emmons, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

A sputum analysis may reinforce the diagnosis of bronchiectasis and add significant information regarding potential etiologies. Once sputum is allowed to settle, the examination may reveal Dittrich plugs, small white or yellow concretions. A Gram stain and culture result may reveal evidence of microorganisms, including mucoid Pseudomonas species and Escherichia coli, which suggest CF but are not diagnostic.

Chronic bronchial infection with nonmucoid Pseudomonas aeruginosa is becoming much more common in patients with non-CF bronchiectasis. The presence of eosinophils and golden plugs containing hyphae suggests Aspergillus species, although this finding alone is not diagnostic of ABPA.

Perform a smear and culture of sputum for mycobacteria and fungi. Atypical mycobacterial infection is a common cause of bronchiectasis in the older population, especially in those with underlying structural lung disease.


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