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Grading System for Sputum Specimens

Purpose: To evaluate the quality of a sputum specimen and to identify those contaminated with oral flora using the score of Murray and Washington.

Description

The Murray and Washington grading system for sputum smears uses leukocytes and oral epithelial cells to help separate suitable from suboptimal specimens.


 

leukocytes per 10x objective (low power)

epithelial cells per 10 x objective (low power)

Group

< 10

> 25

1

10-25

> 25

2

> 25

> 25

3

> 25

10-25

4

> 25

< 10

5

 

Interpretation:

• Groups 1 through 4 show large numbers of epithelial cells, indicating contamination with oropharyngeal secretion. Cultures are typically deferred on these specimens.

• Group 5: clinically relevant. Cultures are typically performed on these specimens.

 

Patterns not "Grouped" above

leukocytes per 10x objective (low power)

epithelial cells per 10 x objective (low power)

< 10

10-25

< 10

< 10

10-25

10-25

10-25

< 10

 

I would not culture the first three, but would the last one.

 


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Specialty

Objective

ICD-10