Sputum stain for mycobacteria

This test requires a sample of sputum.

• You will be asked to cough deeply and spit any substance that comes up from your lungs (sputum) into a special container.
• You may be asked to breathe in a mist of salty steam. This makes you cough more deeply and produce sputum.
• If you still do not produce enough sputum, you might have a procedure called bronchoscopy.
• To increase the accuracy, this test is sometimes done 3 times, often 3 days in a row.

The test sample is examined under a microscope. This sputum stain test can give your doctor a quick answer. Another test, called a culture, is done to confirm the results. A culture test may take several weeks (6 to 10 weeks) to get results.

Drinking fluids the night before the test helps your lungs produce phlegm. It makes the test more accurate if it is done first thing in the morning.

If you are having a bronchoscopy, follow your health care provider's instructions on how to prepare for the procedure.

There is no discomfort, unless a bronchoscopy needs to be performed.

The test is performed when the doctor suspects tuberculosis or other mycobacterium infection.

Results are normal when no mycobacterial organisms are found.

Abnormal results show that the stain is positive for:

• Mycobacterium tuberculosis
• Mycobacterium avium-intracellular
• Other mycobacteria or acid-fast bacteria

There are no risks with this test, unless bronchoscopy is performed.

Acid fast bacilli stain; AFB stain; Tuberculosis smear; TB smear

Rodino KG, Woods GL, Wengenack NL. Mycobacteria. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 59.

Shete PB, Cattamanchi A, Yoon C. Tuberculosis: clinical manifestations and diagnosis. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 53.

Updated by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.