Skin smear microscopy
Skin smear microscopy is an examination of blood, urine, cerebrospinal fluid, pleural fluid, pericardial fluid, and peritoneal fluid for the presence of bacteria. It can diagnose skin diseases caused by streptococci, staphylococcus, anthrax, leprosy, tuberculosis, various fungal infections, amoeba, kala-azar, filariasis, acne, aphids and the like.Basic Information
Specialist classification: skin examination classification: pathogenic microbiological examination
Applicable gender: whether men and women apply fasting: not fastingAnalysis results:
Normal people are negative.
A positive indication is that there may be skin diseases of various bacterial or fungal infections.
Normal people are negative.Clinical significance
(1) When the pharyngeal wall smear is suspected of having pharyngeal diphtheria, the detection of Corynebacterium diphtheriae by smear is of great significance for diagnosis. Pharyngeal and larynx tuberculosis is sometimes smeared (using acid-fast staining) or M. tuberculosis can be found. In the case of gangrenous stomatitis, the detection of Clostridium by smear is also helpful in diagnosis.
(2) Nasal secretions smears Nasal diphtheria or suspected tumor-type leprosy with nasal mucosal damage, mucus smear from the nasal mucosa, the former can find Corynebacterium diphtheria, and the latter may find leprosy.
(3) The pus smear is smeared or cultured with pus to find pathogenic bacteria, which helps to analyze the pathogenic effect of bacteria and select antibacterial drugs. Common purulent bacteria include Staphylococcus, Streptococcus, Streptococcus pneumoniae, Escherichia coli and Pseudomonas aeruginosa.
(4) Skin tissue smears suspected of epidemic cerebrospinal meningitis, scratches on the skin, and exuded tissue fluid smear to find Neisseria meningitidis. Highly suspected leprosy patients, choose the most active skin damage, use a knife to scratch the dermis, scrape tissue fluid smear, if you can find leprosy, it can help diagnose.
(5) Chest, pericardial cavity, abdominal cavity and joint sac smear in pathological conditions, often detect pathogenic bacteria, the most common such as Gram-positive cocci and negative bacilli. When suspected of tuberculous pleurisy, take a smear of pleural effusion or find M. tuberculosis.
(6) If the sputum smear is in the case of hemoptysis, if it is unclear whether it is suffering from bronchiectasis or tuberculosis, it is a sputum smear to find M. tuberculosis, which has differential diagnosis significance.
(7) Urine sediment smear can be left in the middle section of the urine specimen, placed in a sterile container, and checked in time. In the case of cystitis, pyelonephritis and other diseases, Gram-positive cocci or negative bacilli are often seen in the sediment smear. Suspected to be infected with Mycobacterium tuberculosis, you can leave a 24-hour urine specimen, take a sediment smear or find M. tuberculosis.
(8) Cerebrospinal fluid smear Take the cerebrospinal fluid smear microscopic examination to find pathogenic bacteria, which is of great value for clinical diagnosis. Common pathogens include Neisseria meningitidis, Mycobacterium tuberculosis, Gram-positive cocci or negative bacilli, and Cryptococcus neoformans.
(9) Fecal smear In the case of pseudomembranous enteritis, as a fecal smear, staining examination, if a large number of Gram-positive cocci are found, and Gram-negative bacilli are significantly reduced or disappeared, it can be used as a reference for early diagnosis. In the case of intestinal fungal infections, Candida albicans infection is the most common, and fecal smear microscopy can find yeast-like blastospores and pseudohyphae.
(10) If there is fungal vaginitis in the vaginal secretion smear, scrape the secretion a little, smear, stain, microscopic examination to find mold hyphae, spores, the most reliable method is to carry out Candida culture. Suspected that the leucorrhea caused by Neisseria gonorrhoeae increased, smear, staining, microscopic examination of the secretion of the cervix or vestibular gland should be taken. If the intracellular Gram-negative diplococcus is found, it is very diagnostic.
People who need to be examined: skin patients suspected of having streptococci, staphylococcus, anthrax, tuberculosis, and various fungal infections.Positive results may be diseases: mossy rosary, herpes, mossy tuberculosis, acne, acral keratosis, white wind, pediatric congenital ectodermal dysplasia syndrome
Pre-inspection contraindications: Health education should be strengthened for patients and high-risk groups to promote their sexual behavior, avoid non-marital sexual contact, and promote the use of condoms.
Requirements for examination: If diagnosed, timely and adequate use of antiviral drugs to reduce symptoms, shorten the course of disease and control the infection and recurrence of the disease.Inspection process
1. Smear Gram staining: Male urethral patients take urethral secretions, smears, and Gram staining, showing typical intracellular Gram-negative diplococcus.
2. Isolation and culture of Neisseria gonorrhoeae: Female patients, patients with comorbidities and patients outside the genitourinary tract should be isolated and cultured to determine the diagnosis. Colonies with typical morphology and positive oxidase test were isolated from clinical specimens, and colonies were taken for smear examination, and Gram-negative diplococcus was observed. If the specimen is taken from a patient with genitourinary gonorrhea or is of great significance in forensic science, the cultured strain should be further confirmed by a sugar fermentation test or a fluorescent antibody test.
3. Select the inspection item according to the patient's clinical type.
Diagnostic principles: A comprehensive analysis should be performed based on exposure history, clinical performance, and laboratory tests to determine the diagnosis.Not suitable for the crowd
Generally no taboos.Adverse reactions and risks
Generally no complications and harm.