Respiratory
Image Set 9 - (Sparrow 8IIC4) Haemophilus and S. pneumoniae pneumonia
Results: Greater than 100 WBC's/hpf || Numerous gram negative coccobacilli || Moderate gram positive diplococci || Numerous gram positive cocci in chains || Rare large gram positive rods
Note: Study this slide for gram positive diplococci with capsules (typical for S. pneumoniae). The gram positive cocci in chains are most likely normal respiratory Alpha Strep organisms rather than a S. pneumoniae. Haemophilus-like organisms are better viewed for their morphology in fields which are thin and very light. The large gram positive rods may be one of several genera and are probably normal contaminants of this smear.
KEY POINTS: Haemophilus are small gram negative rods that are non-motile and non-spore forming. Haemophilus is a normal part of the respiratory flora in up to 80% of children and 50% of adults. There are both encapsulated and non-encapsulated strains. Over 90% of invasive strains were encapsulated Type B H. influenzae prior to the use of HiB vaccine. After introduction of the HiB vaccine HiB, which had been the leading cause of meningitis in children, is now very rare. S. pneumoniae and Neisseria meningitidis are now the leading causes of meningitis.
Haemophilus and S. pneumoniae pneumonia 01
Haemophilus and S. pneumoniae pneumonia 02
Haemophilus and S. pneumoniae pneumonia 03
Haemophilus and S. pneumoniae pneumonia 04
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