Microscopy (acid fast bacilli)

This test uses a microscope to detect bacteria called acid-fast bacilli in fluid or tissue samples. This test is used to manage mycobacterial infections such as tuberculosis. It may also be used when an atypical mycobacterial infection is suspected. A sample of sputum, bronchial samples, blood, cerebrospinal fluid, urine, stool, or other body fluids or tissues may be collected for this test.

Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. You may need this test if you have:

• Atypical mycobacterial infection
• TB

Sputum:

Before a sputum sample is collected, you may be asked to drink more fluids. Drinking more fluids may help you produce a sputum sample.

Bronchial samples:

A bronchoscopy is a procedure that requires your written consent. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form. Tell the healthcare worker if you have a history of nosebleeds, throat infections, chest pain, heart conditions, or a recent heart attack. Inform the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. You should also report if you have a history of allergic or other reactions to topical anesthetics.

Venous blood:

Before having blood collected, tell the person drawing your blood if you are allergic to latex. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. Also tell the healthcare worker if you have felt nauseated, lightheaded, or have fainted while having blood drawn in the past.

Cerebrospinal fluid:

A lumbar puncture is a procedure that requires your written consent. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form. You may receive certain medications and need imaging tests done prior to the procedure.

Urine:

To prepare for giving a urine sample, be sure to drink enough fluids before the test, unless you have been given other instructions. Try not to empty your bladder before the test.

Stool:

Before giving a stool sample, tell the healthcare worker if you have diarrhea or are using antibiotics, barium, bismuth, oil, iron, magnesium, or medication to stop diarrhea.

Other body fluid or tissue samples:

A different sample other than the samples listed above may be used for this test. Ask your healthcare worker for information about how to prepare for this test. If you have questions or concerns about the preparation for this test, talk to the healthcare worker.

A sample of sputum, bronchial samples, venous blood, cerebrospinal fluid, urine, stool, or other body fluids or tissues may be collected for this test.

Sputum:

Sputum is mucus that is secreted by the airways and lungs. To collect a sample of sputum, you may be asked to cough forcefully, and spit out sputum into a container. If you are unable to produce a sputum sample, you may need to have the sample induced. To induce a sputum sample, a healthcare worker will prepare a solution in a nebulizer for you to inhale. You will be asked to inhale the solution over a period of time, which may last up to 20 minutes. You will then be asked to cough and spit out sputum into a container.

Bronchial samples:

A bronchial (lower airway) sample is collected during a bronchoscopy. During a bronchoscopy, bronchial cells and secretions may be collected using one or more of several different methods.

A bronchoscopy is done with general anesthesia or conscious sedation. Your vital signs will be monitored and a ventilator may assist your breathing. The bronchoscope, a flexible fiberoptic instrument, is passed through your nose or mouth. If the scope is passed through your mouth, a bite block may be used to protect your teeth. The bronchoscope then passes through your airways and into your lung. A topical anesthetic is often sprayed down the tube to prevent coughing during the procedure.

During the bronchoscopy, your airways are inspected and samples of cells or tissue may be collected using bronchioalveolar lavage, bronchial brushing, and/or bronchial biopsy. A bronchioalveolar lavage is done by placing the tip of the bronchoscope into an area of your lung. Saline solution is injected and drawn out through the scope. This procedure is usually repeated several times to collect samples of cells and secretions from different areas of the lungs. During bronchial brushing, a small brush within the scope is used to collect samples of cells from the lung. When a biopsy is needed, an instrument located within the scope is used to collect samples of tissue from the lung.

Venous blood:

When a blood sample from a vein is needed, a vein in your arm is usually selected. A tourniquet (large rubber strap) may be secured above the vein. The skin over the vein will be cleaned, and a needle will be inserted. You will be asked to hold very still while your blood is collected. Blood will be collected into one or more tubes, and the tourniquet will be removed. When enough blood has been collected, the healthcare worker will take the needle out.

Cerebrospinal fluid:

Cerebrospinal fluid is the fluid that surrounds the brain and spinal cord tissues. The procedure that collects a sample of cerebrospinal fluid is called a lumbar puncture. For this procedure, you may need to lie on your side facing away from the person performing the procedure. You may be asked to roll up into a ball with your knees brought close to your chest. This position allows your spine to spread apart slightly and helps direct needle placement. This procedure may also be done while you are in an upright sitting position, with your knees drawn up toward your chest.

An area in the lower back will be chosen for the needle insertion site. This is about at the level of the top of your hip bone. Your skin will be cleaned with antiseptic and the area will be draped with sterile cloth. Local anesthetic will be injected with a small needle to numb the area. Anesthetic cream may also be applied. After the anesthetic has taken effect, the lumbar puncture needle is inserted between the vertebrae and into the spinal column. Cerebrospinal fluid is drawn out for testing and the needle is removed. You may need to change positions during the procedure if the healthcare worker is having difficulty collecting a sample of fluid. This procedure may be done more than one time if collecting cerebrospinal fluid is difficult.

Urine:

To provide a sample of urine, you will be asked to urinate into a container. Fill the container as much as you can, but do not overfill it. Urine samples may also be taken from a catheter.

Stool:

For a stool sample, you will be asked to have a bowel movement into a special container. Avoid adding urine, water, tissues, or toilet paper to the stool sample.

Other body fluid or tissue samples:

A different sample other than the samples listed above may be used for this test. Methods used to collect other body fluids or tissue samples may vary. Ask the healthcare worker to explain how this sample may be collected. If you have questions or concerns about this test, talk to the healthcare worker.

The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the test. Inform the person doing the test if you feel that you cannot continue with the test.

Sputum:

Generally, collection of a sputum sample is not painful. If the sample is induced, the coughing may be uncomfortable.

Bronchial samples:

During a bronchoscopy, general anesthetic or conscious sedation may be used. General anesthesia is done by an anesthesiologist. You receive medicine that puts you into a deep sleep where you are unable to feel pain. With conscious sedation, you receive medicine that puts you in a dream-like state, where you should not feel pain or remember the procedure. However, you are still awake enough to move and respond to directions. After the procedure, you may have a sore throat or cough for several days

Venous blood:

During a blood draw, you may feel mild discomfort at the location where the blood sample is being collected.

Cerebrospinal fluid:

Before a lumbar puncture, a local anesthetic is given to the procedure site to numb the area. You may feel mild discomfort or stinging when the numbing medicine is injected. You may feel a pressure, a popping sensation, and discomfort when the procedure needle is inserted. Tell the person doing the test if you feel pain or numbness down your leg during the procedure. You may have back discomfort for several days after the procedure.

Urine:

This test usually causes no discomfort.

Stool:

This test usually causes no discomfort.

Other body fluid or tissue samples:

A different sample other than the samples listed above may be used for this test. This test may feel different depending on many factors, including the sample needed and how it is collected. Ask the healthcare worker what to expect during this test.

Sputum:

After a sputum sample is collected, call the healthcare worker if you experience a new onset of pain in your throat, trouble swallowing, or if you are coughing up blood.

Bronchial samples:

Following a bronchoscopy and collection of a sample of cells or tissue, you will need to rest until healthcare workers say that you are able to leave the facility. You can usually eat and drink as you normally do soon after the procedure. You may have a sore, dry throat for a short time, and you may develop a slight fever the evening after the procedure.

Contact your healthcare worker if you cough up significant amounts of bright red or dark-colored blood, or have a high fever, which remains for several days. Contact your healthcare worker immediately if you have sudden or a new onset of chest pain, shortness of breath, wheezing, or other difficulty breathing.

Venous blood:

After a blood sample is collected from your vein, a bandage, cotton ball, or gauze may be placed on the area where the needle was inserted. You may be asked to apply pressure to the area. Avoid strenuous exercise immediately after your blood draw. Contact your healthcare worker if you feel pain or see redness, swelling, or discharge from the puncture site.

Cerebrospinal fluid:

After the lumbar puncture is complete, a bandage will be placed over the site and pressure held until the bleeding or drainage has stopped. You will need to lie flat for at least 1 to 2 hours after the lumbar puncture. Healthcare workers will monitor for drainage from the puncture site for a period of time after the test. You may be able carefully turn from your back to your side. You will be offered fluids to drink.

Urine:

After collecting a urine sample, close the container if it has a lid. Place the container where the healthcare worker asked you to put it. Clean your hands with soap and water.

Stool:

After giving a stool sample in a healthcare facility, close the container if it has a lid, and place the container where the healthcare worker instructed. Clean your hands with soap and water. If you have been asked to collect the stool sample while at home, follow the directions provided.

Other body fluid or tissue samples:

A different sample other than the samples listed above may be used for this test. Instructions for what to do after a collection of other body fluid or tissue samples may vary. Ask the healthcare worker to instruct you on what to expect after this test is completed. If you have questions or concerns about what to expect after the test is completed, talk to the healthcare worker.

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.