GS204-1

Gram – Join Fluid: 3+ (6-10/oif) neutrophils –3+ (11-50/oif) gram negative bacilli (Kingella kingae) – Shipped February 08, 2021

HISTORY

A simulated joint fluid sample collected from 6 year old with sore knee was sent to category A and C1 laboratories. Participants were expected to report the presence of neutrophils and gram negative bacilli.

MAIN EDUCATIONAL POINTS from GS204-1

  1. Accurate examination of Gram stains prepared from joint fluids is crucial to support empiric antimicrobial therapy and patient management.
  2. K. kingae may be erroneously identified as gram positive on staining due to its propensity to resist decolorization and retain crystal violet dye.
  3. Reporting epithelial cells incorrectly may suggest skin contamination of the sample which might lead to misinterpretation of Gram stain results.

Full critique (PDF)

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