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Diagnosing Infectious Diseases
Diagnosing Infectious Diseases
High-quality clinical specimens are required to achieve accurate, clinically relevant laboratory results (i.e., results that provide information about the patients infectious disease).
Introduction
The proper diagnosis of an infectious disease requires: 1. Taking a complete patient history 2. Conducting a thorough physical examination of the patient 3. Carefully evaluating the patients signs and symptoms and 4. Implementing the proper selection, collection, transport, and processing of appropriate clinical specimen
Clinical Specimen
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Refers to the various types of specimen (e.g., blood, urine, feces, cerebrospinal fluid) that are collected from patients and used to diagnose or follow the progress of infectious diseases
Hair clippings Nail (fingernail and toenail) clippings Nasal swabs Pus from a wound or abscess Scotch tape prep Skin scrapings
F F B B P F
Skin snip
Sputum Synovial (joint) fluid Throat swabs Tissue (biopsy and autopsy) specimens Urethral discharge material Urine Urogenital secretions (e.g., vaginal discharge material, prostatic secretions) Vesicle fluid or scraping * B, BACTERIAL INFECTIONS ; F, FUNGAL INFECTIONS
P
B, F, P B B, V B, F, P, V B B, P, V B, P V * P, PARASITIC INFECTIONS; V, VIRAL INFECTIONS
Laboratory findings must then be conveyed to the attending physician as quickly as possible to facilitate the prompt diagnosis and treatment of the infectious disease. Healthcare professionals who collect and transport clinical specimens should exercise extreme caution during the collection and transport of clinical specimens to avoid sticking themselves with needles, cutting themselves with other types of sharps, or coming in contact with any type of specimen. Healthcare personnel who collect clinical specimens must strictly adhere to the safety policies known as standard precautions.
According to the Clinical and Laboratory Standards Institute (CLSI), All specimens should be collected or transferred into a leakproof primary container with a secure closure. Care should be taken by the person collecting the specimen not to contaminate the outside of the primary container . Within the institution, the primary container should be placed into a second container, which will contain the specimen if the primary container breaks or leaks in transit to the laboratory.
ultimately responsible for its quality. When clinical specimens are improperly collected and handled, 1. the etiologic (causative) agent may not be found or may be destroyed 2. overgrowth by indigenous microflora may mask the pathogen , and 3. contaminants may interfere with the identification of pathogens and the diagnosis of the infectious disease