Materials and Methods Subjects Seventeen patients with HP, including five cases of summer-type HP which is a unique type of HP in Japan, five cases of bird fanciers lung, one case of isocyanate HP, and six cases of HP of unknown cause were investigated. The diagnosis was based on history, clinical evaluation, and radiologic patterns,…
Hypersensitivitv pneumonitis (HP) occurs after exposure to a variety of environmental antigens. An acute phase of HP is assumed to be triggered by the massive inhalation of the relevant antigens leading to the development of immune complex disease followed by T-cell-mediated hypersensitivity reactions. There are reports that chronic HP develops into lung fibrosis after a…
Thus, it is probable that the volume of fluid plated with the two techniques reflects a similar concentration of bacteria in lung secretions. This hypothesis is supported by the strong correlation between TPC and BAL quantitative cultures we found. Furthermore, our data are comparable with studies in mechanically ventilated patients, studies in baboons, and a…
Kahn and Jones evaluated 75 patients for the presence of bacterial lower respiratory tract infection. Thirteen patients with bacterial pneumonia were included; unfortunately, five patients had a hematologic malignancy and two had a lung abscess. Of the remaining six patients, three were receiving antibiotics when subjected to bronchoscopy. The authors suggest a cutoff point of…
These results are comparable with our data in that S pneumoniae is the main organism involved in CAP We agree with Ortqvist et al that bronchoscopy can be performed without major risks and that it is a useful tool in the severely ill patient and also in the moderately ill patient who cannot produce a…
Discussion The results of this study demonstrate that quantitative BAL cultures are as reliable as TPC cultures in diagnosing etiology of CAP Few studies have examined the diagnostic value of bronchoscopic techniques in patients with CAP. Sorensen et al studied 36 patients with severe CAP and performed a very thorough diagnostic study that included bronchoscopy…
The relationship between the results of quantitative cultures of TPC and BAL specimens for the microorganisms isolated in 30 patients (r = 0.71; n = 32; p<0.0001) is shown in Figure 1. In 28 (70 percent) of the 40 cases studied, quantitative TPC cultures yielded ^lO cfu/ml. In all but one of these cases, BAL…
Statistical Analysis Results are expressed as mean ± SD. Quantitative cultures of BAL and TPC are compared by linear regression. Results In 28 (70 percent) of 40 cases of CAP studied, a definite etiology was confirmed by microbiologic methods. Results are shown in Table 1. Altogether, 31 microorganisms were cultured in significant counts; S pneumoniae…
Microbiology Procedures TPC and BAL samples were processed within 20 min of collection according to the procedure described by Winterbauer et al. Briefly, after vortexing for 60 s both samples were serially diluted by factors of 10, 100, and 1,000, then plated in blood agar and chocolate agar media, and incubated in aerobiosis and in…
Bronchoscopy Procedure Bronchoscopy was performed within 12 h after hospital admission. Patients were premedicated with salbutamol (200 jig) and atropine (0.5 mg). Lidocaine was aerosolized to nose and pharynx and 50 percent oxygen was delivered by mask. Next, intravenous midazolam (2 to 10 mg) was administered. A fiberoptic bronchoscope was inserted transnasally with the patient…
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