What is the role of sputum evaluation in the workup of bacterial pneumonia?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Sputum Gram stain and culture should be performed before initiating antibiotic therapy (if a good-quality, contaminant-sparse specimen containing < 10 squamous epithelial cells per low-power field can be obtained). The white blood cell (WBC) count should be more than 25 per low-power field in non-immunosuppressed patients.

A single predominant microbe should be noted at Gram staining. Mixed flora may be observed with anaerobic infections.

However, often, patients cannot produce an adequate specimen. Many specimens produced are so contaminated by oral materials that the results of stains and cultures are unreliable.

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