Lab- Urines and CSF

This week in lab we looked at urines and spinal fluids. The case I was given for CSF was a 13-month old child who was admitted a grand mal seizure, temperature, increased pulse and respiratory rate. He was lethargic, irritable, and a stiff neck. A lumbar puncture was performed and the WBC count of 4,650/ µL with 95% neutrophils, glucose of 48 mg/dL and protein of 107 mg/dL. I first gram stained the primary smear and quantitated the bacteria seen. There were more than 30 bacteria seen in each field observed (average), and they were described as some short rods, some pleomorphic rods, with some coccobacilli. The SBA media had pinpoint, grayish, translucent colonies satelliting with a quantitation of 4+. The chocolate agar also was quantitated at 4+ with smooth translucent gray colonies. We also gram stained a slide from the inoculated thioglycollate broth. This showed a possible contaminate because along with the long pleomorphic rods expected, there were gram positive cocci seen. With these findings, an API NH was done with a presumptive ID of Haemophilus. The API strip confirmed the child had an infection due to Haemophilus influenzae.

Gram stain negative pleomorphic rods with coccobacilli



Pseudomonas aeruginosa on SBA

Coagulase negative Staphlococcus

The urine specimen I had was plated on SBA, MAC, and Chromagar. On SBA, there were small white opaque colonies >100,000 CFU/mL, no growth on MAC, and >100,000 CFU/mL of white colonies on Chromagar. The presumptive ID was Staphlococcus. A catalase test was positive, Staphaurex negative, and Novobiocin sensitive. With these results, the final identification was Staphlococcus, coagulase negative. Then we plated/ streaked our urine specimen on to SBA, MAC, and Chromagar. I read the plates on Thursday and the SBA plate was very typical of Pseudomonas (grayish green, beta hemolysis, taco odor). The colonies were clear on MAC, and beige on Chromagar. The oxidase test was positive and spot indole negative and ID was Pseudomonas aeruginosa.