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How to Make Sense of Laboratory Analyses in Respiratory Cases?
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The microbiological analysis of respiratory fluids, generally performed in the laboratory is, along with cytological evaluation of these fluids, an ancillary examination of choice in the clinical and functional investigation of the respiratory system. This presentation aims to provide the practitioner with sufficient information to be able to interpret objectively both isolation and quantification of infectious agents in respiratory fluids, as performed by the laboratory. Microbiological assessment classically includes virology, parasitology, bacteriology and mycology. These methods are conventionally used in three situations: - when clinical signs are present, suggesting an acute disease (purulent nasal discharge ...); - when non specific clinical signs are observed (cough ...); - when clinical signs are not obvious or even absent (poor-performance ...). The upper respiratory tract represents the area predominantly involved in primary replication of many viruses (e.g. rhinitis viruses, herpesviruses, influenza). Analysing nasopharyngeal swabs is therefore the method of choice for microbiological investigation during suspected acute respiratory infectious disease. Concerning respiratory fluids, TW is a sample collection technique both easy to perform and, in some circumstances, potentially useful. All microbiological investigations (virology, parasitology, bacteriology and mycology) may be performed on this fluid. In the same principle, lavage fluid may be collected from guttural pouches for bacteriological research. While some contamination of these different samples may occur, it is almost impossible to achieve a bronchoalveolar lavage (BAL) sample whilst avoiding nasopharyngeal contamination. Microbiological investigation of this latter sample is therefore not recommended as a routine procedure. Ideal conditions for storage and shipment are with the fluid being placed into a dry tube after homogenisation, and sent as soon as possible to the laboratory (preferably at 4oC for bacteriology and either 4°C or -20°C for virology). […]
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Affiliation of the authors at the time of publication
Université Caen, Normandie, Saint-Contest, France.
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