Analyzes for acute and chronic bronchitis: a study of blood, sputum, urine

Bronchitis is a frequently occurring serious disease of the respiratory system of an inflammatory nature, affecting the bronchial tree. Traditionally, it can occur as a complication after the invasion of a viral or bacterial infection. By the duration of inflammation of the bronchi classified into acute and chronic. Symptoms of acute catarrhal bronchitis progress from several days to 1 month. The signs of the disease are identical to the symptoms of ENT diseases affecting the upper segments of the respiratory system. A characteristic feature of chronic bronchitis is a dry or spitting excretory compulsive cough that does not stop for a long time. This type of bronchitis can provoke smoking or non-infectious irritating factor. To determine the cause that caused the inflammatory process in the bronchial tree, the patient should undergo a thorough examination and carry out the necessary tests.

[1], [2], [3], [4], [5]

Indications for conduction

The basis for conducting tests for suspected inflammation in the bronchi is the presence of an appropriate clinical picture:

• prolonged cough (dry or wet);
• painfulness in case of coughing in the chest area;
• feverish condition;
• symptoms of intoxication.

To confirm or disprove the previously diagnosed bronchitis, the doctor prescribes an analysis of characteristically changing blood counts, culture and sputum microscopy, and urinalysis.

What tests should I take with bronchitis?

When diagnosing acute bronchitis, doctors recommend:

• general examination of blood and urine;
• test parameters of the biochemical composition of the blood;
• sputum smear;
• sputum sputum with the determination of the sensitivity of the pathogen of infection to antimicrobial agents;
• determination of the gas composition of arterial blood.

Analgesia for bronchitis in adults

From a wide range of studies, adult patients with inflammation of the bronchial tree are required to:

• Clinical examination of blood.
• General analysis of urine.
• Biochemistry of blood.
• Bacteriological analysis of sputum.
• Serological tests for the detection of antibodies to various disease provokers.

In adults with acute bronchitis of bacterial genesis, test results of a general analysis of capillary blood indicate a high content of neutrophils, indicating inflammation, several times increased ESR. In venous blood, the concentration of gamma globulins, alpha globulins and proteins increases. Development of hypoxemia, with an increased concentration of oxygen in the gas composition of the blood. In serological studies, various titres of antibodies to mycoplasma, viruses, and bacteria can be detected. With a prolonged course of purulent chronic bronchitis, a positive CRP (C-reactive protein) is determined.

If the bronchitis of allergic genesis, the level of leukocytes remains within normal limits. The content of neutrophils and lymphocytes does not exceed the limit of standard normal indices, provided that the patient does not have concomitant chronic diseases. ESR moderately increased. The number of eosinophils increases. In biochemical analysis, an increase in seroglioids and sialic acids is recorded.

The indicators of microscopic examination of sputum will differ for different types of bronchitis. For acute catarrhal bronchitis (Bronchitis catarrhalis acuta), mucus is characteristic, in consistence resembling jelly. It contains neutrophilic granulocytes and epithelial cells. Localization of the focus of inflammation is determined according to the type and size of the observed epithelial cells of the bronchial tree. If the material appears large ciliate epitheliocytes - this indicates that the focus of inflammation is in the main bronchi or lower segments of the trachea. Detection of epithelial cells of medium size indicates an inflammatory process in the middle bronchi with a diameter of 2-5 mm. If the infection affects small bronchi, then small epithelial cells are observed in the sputum. When inflammation of the bronchioles in the test material reveals small epitheliocytes and detect Kurshman spirals (dense strands of mucus).

Acute catarrhal-purulent bronchitis is characterized by the presence of purulent-mucous exudate, moderately viscous density with increased concentration of leukocytes and a relatively small content of epithelial cells.

When acute purulent form of bronchitis is detected in a large leukocyte concentration. Epithelial cells are not visualized, the presence of single red blood cells can be noted.

For all types of acute bronchitis inflammation of the bronchial mucosa is characteristic with the formation of a fibrinous film separable from the walls and evacuated from the lungs together with sputum in the form of a mucus lump during a strong cough thrust.

When asthmatic bronchitis is released a small amount of viscous sputum, which contains eosinophils, Charcot-Leiden crystals, Kurshman spirals, epithelial cells, fibrin.

For chronic bronchitis is characterized by the detection of substances in the sputum of pollutants (toxic substances that negatively affect the function of the bronchial tree). Such substances include tobacco tar, poisonous substances of industrial production.

The general analysis of urine in acute and chronic bronchitis has no characteristic changes, there is an increase in the number of flat epithelium and the presence of single white blood cells or their accumulation.

[6], [7]

Analyzes for bronchitis in children

To determine the cause of inflammation of the bronchial tree and determine the location of the infectious focus in the lungs, children of the child's age are assigned the same laboratory and instrumental examinations as adults. By the characteristic features of a general analysis of the elements of the composition of capillary blood, one can determine the genesis of the disease - inflammation of the bacterial, viral or allergic etiology. With the help of general analysis, differential diagnosis of allergic pathology and inflammatory process of the viral-bacterial nature is carried out.

Sputum analysis helps to assess the state of lung and bronchial structures in a child. The study is conducted for diagnostic purposes to determine:

• forms of bronchitis;
• confirmation or refutation of the diagnosis: bronchial asthma;
• severity of the condition of a small patient with pulmonary edema,
• differentiation of pneumonia and bronchitis;
• type of respiratory disease.

Examination of sputum makes it possible to determine as precisely as possible the type of pathological process in the bronchial tree, and in some cases to determine etiology.

In children under the age of 3, respiratory infections, the presence of influenza, adenovirus or cytomegalovirus viruses lead to acute bronchitis. Bronchitis caused by microorganisms leads to the symptoms of obstruction rarely. Three-year-olds and older can cause bronchitis Mycoplasma (Mollicutes), chlamydia (Chlamydia trachomatis), intracellular parasitic protozoa. In order to determine the pathogen in obstructive bronchitis in children, an analysis of antibody titres in the blood stream for mycoplasmosis and chlamydia is performed. If untimely started treatment or incompetent diagnosis and prescription of pharmacological agents, these diseases cause serious complications, therefore analysis is mandatory. A blood test helps diagnose:

• Mycoplasmosis is a disease that has a symptom complex that is identical to the catarrhal symptoms.
• Pulmonary chlamydia is a respiratory infection caused by chlamydia.

In childhood, it is important to differentiate bronchitis of infectious and allergic etiology. It will help to establish and confirm an accurate diagnosis of the presence in the anamnesis of allergic reactions and the heredity of this pathology. Typical changes in laboratory tests will indicate the allergic nature of the symptoms of bronchitis. Infectious obstructive inflammation of the bronchial tree is closely related to the presence of respiratory-viral infections. Symptoms develop gradually with the presence of hyperthermia. Bronchitis of allergic genesis does not have a clear dependence on the presence of signs of acute respiratory viral infection. It begins to actively manifest after contact with a specific allergen. The diagnosis is confirmed by an increase in total IgE in the blood serum and skin tests for allergic reactions with the definition of a provoking allergen.

[8], [9], [10], [11], [12], [13], [14]

Analyzes for chronic bronchitis

Chronic bronchitis is a persistent disease of the bronchi of inflammatory etiology, characterized by a recurring course over a long period of time (more than two years). If you suspect a chronic bronchitis, the patient should perform diagnostic procedures and undergo examinations:

• a common clinical blood test with a formula,
• general analysis of urine,
• biochemical blood test,
• sputum bacillus,
• Determination of serum antibody titres.

In the period of calm of inflammatory reactions in the bronchial tree, the overall clinical analysis of capillary blood does not have any significant changes. During an exacerbation or recurrence of bronchitis, an increase in the concentration of leukocytes, an increase in ESR, a shift of the leukocyte formula to the left is observed in a clinical study of blood. Serological tests for antibodies to various types of infection are recommended in the event that bronchitis is practically not amenable to therapy, has frequent relapses and short remissions.

[15], [16]

Analyzes for acute bronchitis

Acute bronchitis is a complication after the invasion of viruses, pathogens, local irritants. The disease is often combined with inflammation of the nose, pharynx, and trachea. Doctors note the characteristic seasonality (spring-autumn period) of the appearance of diseases. In the general clinical analysis of blood, there is increased leukocytosis, an increase in ESR. In biochemical indicators, the concentration of sialic acids, alpha, gamma globulins increases significantly, C-reactive protein appears, the activity of angiotensin-converting enzyme (ACE) increases, hypoxemia may occur. To detect the pathogen, it is necessary to conduct sputum smear analysis, which will allow the appointment of competent treatment. The serological study is aimed at identifying antibodies to pathogens, which will help the doctor in correctly diagnosing and prescribing adequate therapy. Serological analysis can confirm the presence of various viruses, Mycoplasma pneumoniae, Haemophilus influenzae, pneumococcus (Streptococcus pneumoniae), Gram-negative cocci (Moraxella catarrhalis).

In acute bronchitis, sputum consists of mucus with a small amount of purulent impurities. Examining sputum with pus, ascertain the presence of neutrophilic granulocytes, bronchial epitheliocytes, mononuclear phagocytes, Kurshman spirals.

Immunological studies of blood confirm the decrease in the concentration of T-lymphocytes and T-suppressors.

[17], [18], [19], [20]

Analyzes for obstructive bronchitis

Given the clinical picture of the disease, to clarify the diagnosis, with obstructive bronchitis appoint:

• General clinical analysis of blood.
• Microbiological examination of sputum.
• The PCR method for determining the type of pathogen in the blood stream and sputum.
• Spirometry is used to assess the degree of obstruction.

Based on clinical symptoms, taking into account the results of the above types of examinations, the doctor confirms or refutes the diagnosis of obstructive bronchitis.

[21], [22], [23], [24], [25]

Blood test for bronchitis

To determine the severity of the inflammatory process in the bronchial tree, a clinical analysis of capillary blood is necessary.

The test values of a clinical blood test may change and give false information if the patient did not comply with the rules for preparing for the analysis. On the eve of the manipulation it is necessary to reduce the intensity of physical exertion, completely eliminate salt, spicy, fatty foods. Alcoholic and carbonated drinks are forbidden. Test test results will be more accurate if at least 8 hours pass between the intake of material and the last meal. Babies break may be 2-3 hours.

Blood is collected strictly on an empty stomach. For the study used capillary or venous blood (in the direction always indicates that the blood is venous). Before recruiting material, the laboratory assistant of the medical institution conducts the treatment of the working area with 70% alcohol solution. For sampling of capillary blood, a test tube, a special glass thin capillary, slide glass and other laboratory instruments will be required. The procedure is carried out by puncturing a finger with a special sterile spear scarifier. Before taking on the analysis of venous blood, a nurse or laboratory assistant applies a tourniquet just above the site of the material selection. The skin in the area of the prospective venepuncture is treated with 70% alcohol and blood is collected using a syringe.

Biochemical blood test for bronchitis

A biochemical blood test is a complex examination showing the change in the content of globulins and the presence of a C-reactive protein. Thanks to biochemistry, it is possible to obtain a general picture associated with metabolic processes and the concentration of various constituents. For the reliability of the indicators, it is necessary to stop eating 12 hours before the procedure, only pure still water is allowed. Blood is collected from the vein with a sterile syringe. Then place in a sterile tube. It is possible to draw blood into a vacuum sterile tube. The material is delivered to the laboratory within 24 hours. After 1-3 working days, the results will be ready.

[26], [27], [28], [29]

Sputum analysis for bronchitis

Bacteriologic examination of sputum will help determine the causative agent (Koch bacteria, the introduction of pinworms or other types of worms) that caused the onset and development of the disease. The doctor pays close attention to the microscopy of the discharge of bronchitis and the presence of characteristic components:

• Epitheliocytes of the bronchi.
• Macrophages (mononuclear phagocytes).
• Erythrocytes.
• Leukocytes.

Bronchial epitheliocytes present in the sputum are not the main indicator of the inflammatory process in the bronchial tree. The norm of the maintenance of bronchial epithelial cells in the test sample is up to 10 units on a special scale. If a high concentration of epithelial cells is noted in the analysis of sputum, this is a confirmation of the presence of inflammation of the mucous membrane of the bronchi and the trachea. Clinically, the presence of a focus of inflammation in the bronchi confirms an unproductive obtrusive cough with pain in the chest.

Mononuclear phagocytes are constantly present in sputum, but with persistent inflammation they increase significantly.

Leukocytes (white blood cells) in a single amount are necessarily present in the sputum, but with inflammation their concentration increases significantly.

The appearance of erythrocytes indicates a deep lesion of the bronchi affecting the integrity of capillaries and larger vessels. It can lead to traumatization of tender epithelial tissue, an obsessive cough with bronchitis.

To obtain reliable results of sputum examination in the inflammatory process in the bronchial tree, the patient should adhere to the following recommendations:

Systematically take expectorants on the eve of the study, and also shows a plentiful drink.

For the study, fresh sputum is required, preferably without an admixture of saliva.

To obtain accurate results, take a sterile medical container.

To collect material with a small amount of sputum produced, it is necessary to cause a reflex cough with deep breaths.

Urinalysis of bronchitis

Urine examination with bronchitis is necessary to exclude specific renal pathologies, gallbladder diseases. The indicators defined in the urine are influenced by a variety of reasons:

• food;
• drinking regime;
• intensive sports;
• active physical work;
• transferred stressful situations;
• taking medications and food supplements.

To obtain an accurate result, the correct preparation for a general urinalysis should be done:

• 1 day before the test, it is necessary to exclude from the diet products that affect the color indices of urine (fruits and vegetables with bright colors, smoked meat, marinades);
• contraindication of drinking alcoholic beverages, vitamins, coffee, strong tea;
• visiting the sauna, sauna on the eve of the study is excluded;
• it is necessary to warn the doctor who prescribed a referral to the urinalysis, about taking medications;
• in women during menstruation, urinalysis is usually not performed. The exception is made by emergency cases, when the material for the study is typed by the urethral catheter;
• Contraindications to the delivery of urinalysis in bronchitis are high figures of body temperature and blood pressure. They significantly affect the indicators and the results of the study will be distorted.

Collection of urine is carried out in special containers. The test portion of the material should not contain any foreign inclusions and impurities. Follow simple recommendations for collecting urine:

• a general urine analysis is performed by examining the morning dose of urine;
• Before proceeding to collection of urine, it is necessary to conduct hygienic procedures to reduce the ingress of bacteria and obtain a more reliable result;
• to collect a portion of urine, you need a clean, preferably sterile, container. It should not have a detergent residue. You can buy special containers that are sold in the pharmacy network;
• urine, necessary for general research, can be stored in a cool place for no more than 2 hours;
• To collect the test material, infants use sterile medical packages to collect urine, otherwise the recommendations for children on urine delivery are the same as for older patients. It is forbidden to collect urine for research using a diaper. The result will be inaccurate due to filtering the urine through the tissue and entering the sample of microscopic fibers.

Decoding the blood test for bronchitis

In the general blood test, laboratory assistants determine the number of erythrocytes, the total number of leukocytes, platelets, hemoglobin, color index, ESR, and consider the formula (percentage of leukocytes of different species). In the analysis of blood in bronchitis, some indicators change.

Erythrocytes (RBC) are the red cells of the bloodstream, synthesized by the tissues of the bone marrow. Their main function is the delivery of oxygen to various cellular structures of the body, maintaining a stable process of oxidation at the cellular level and removing carbon dioxide. With bronchitis there is a slight increase in the concentration of erythrocytes, because in the bronchial tree acid-base and water-salt balance is disrupted, and red blood cells participate in its control.

In a child or adult with bronchitis, white blood cells (WBC) are the main indicators of the state of the immune system. Their function is to fight against viruses, bacteria, mycotic infection, allergens. A sharp increase in the number of leukocytes in the bloodstream should be alarming. In this situation, an urgent appeal to a specialist who will prescribe a comprehensive examination of the body. If bronchitis is not started, then a slight increase in the level of white blood cells is considered normal. Norm of white blood cell counts:

• in adults from 4 to 9 (10 in 9 degrees per liter),
• in children 6-11 (x 10 in 9 degrees per liter).

With bronchitis, the concentration of leukocytes can double.

ESR (RBC) - erythrocyte sedimentation rate is a nonspecific marker of inflammation. The indicator of ESR always increases with the manifestation of bacterial infections during the acute phase of the disease. The focus of the infectious process may be in different organs and systems, but in the peripheral blood the inflammatory reaction is always reflected. The level of ESR is also increased in cases of viral genesis. Considering the aforesaid, with bronchitis of a viral or bacterial nature, this indicator will be quite high.

If the symptomatic complex of bronchitis is strongly pronounced, laboratory tests are needed to determine its genesis and to prescribe adequate treatment. Analyzes with bronchitis allow us to establish what led to the appearance of inflammation. Correctly diagnosed and timely begun complex treatment will avoid serious complications caused by inflammation of the bronchial tree.

[30], [31], [32]