Role of the microbiology laboratory tests in diagnosis inflammation of the upper respiratory tract

Abstract

Infections of the upper respiratory tract are one of the main reasons why patients visit their primary care physician. Most of these are viral infections, requiring only symptomatic treatment. In the case of infections of bacterial etiology, apart from thorough medical history and physical examination, microbiological tests play an important role. They allow for the precise identification of the microorganism and determine sensitivity to antibiotics. Avoiding unjustified or wrong antibiotic therapy supports the fight against multi-drug resistant organisms, which are an increasing challenge for modern medicine. One of the most common causes of pharyngitis is Streptococcus pyogenes infection. Despite the possibility of performing rapid antigen detection test, pharyngeal culture remains the gold standard in the diagnosis of bacterial infections in this area. Otitis media is considered by the authors as well as sinusitis. The primary ethiology of the otitis media are viruses following the dysfunction of the Eustachian tube, which causes secondary bacterial infection. The anatomical structure of the middle ear prevents direct collection of material for microbiological examination, except in the case of spontaneous perforation of the tympanic membrane or paracentesis. Sinusitis is mostly viral infection and is diagnosed based on clinical symptoms. In the routine diagnosis of rhinosinusitis, microbiological testing is not recommended, however the authors discuss the principles and indications for extending the diagnostics. The following article argues the most common pathogens responsible for infections in the mouth, throat, middle ear, and paranasal sinuses. The authors pay special attention to the quality of the collected material, protection of the sample and the method of transport to the laboratory. Compliance with the following standards in everyday clinical practice may reduce the percentage of non-diagnostic results and will help in making an accurate diagnosis.