Sputum induction is a procedure used to collect adequate lower respiratory secretions from patients who have trouble producing sputum to aid the diagnosis of TB. In tuberculosis (TB), three sputum samples must be collected on three consecutive days and be returned to the clinical lab each day. If the patient leaves the specimen in the refrigerator after collection, there is often a tolerance range, which may run well over 24 hours. Routine sputum culture requires that one sample is collected and sent to the lab on the same day of collection. If the patient has difficulties coughing up enough sputum, the medical professionals may apply some physiotherapeutic maneuvers, which allow the progressive release of the sputum. It is paramount that the lid of the container where the first fluid is collected is changed to avoid contaminations. In some settings, the procedure can be repeated until 10 to 20 mL of sputum sample has been collected. In several institutions, clear and runny samples are not acceptable for further microscopic or microbiological studies. The medical professionals will check the amount and gross qualities of the sputum, which should be thick to allow a proper investigation by the laboratory medical staff. The sputum is then released in a sterile well-closed container provided by the medical professionals to the patient. After expelling saliva, the patients then breathe in deeply three times to cough at 2-minutes intervals until bringing up some sputum. At first, the patients need to rinse out the mouth with clear water for 10-15 seconds to eliminate any contaminants in the oral cavity. Commonly, the "deep cough" sample of the early morning is collected before eating or drinking anything to avoid bias in interpreting the results. Thus, some maneuvers of physiotherapy may be considered adjuvant for getting some material for the analysis. However, in some clinical settings, the approach may be more vigorous due to the inability of the patient to expel such fluid from the upper respiratory tract. The procedure of sputum specimen collection is usually non-invasive. Clinically, sputum molecular biomarkers or gene sequencing of the microorganisms have increased medicine accuracy and represent a milestone in the current evaluations of the algorithms running for precision medicine. The sputum analysis involves an analytical approach to investigate the cellular and acellular components expelled from the patient's upper respiratory tract. This procedure is essential in the evaluation and management of lower respiratory infections or other longstanding health conditions. The sputum contains various cells and molecular compounds such as soluble lipids and proteins. The sputum is examined grossly and microscopically to aid medical diagnosis. The mixture of saliva and mucus specifically coughed up from the respiratory tract, often either following an infection or an irritation of the mucosa, is precisely labeled "sputum." The term phlegm arises from the Greek word "φλ?γμ?" which in the ancient books of medicine was used to label humor caused by heat. In the setting of an infection or a longstanding health condition, the term phlegm is also used. Mucus is the fluid secreted by the airways (also known as bronchial and windpipes) and lungs.
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