Chlamydia pneumoniae (TWAR stain) is a newly isolated species of the Chlamydia genus recently recognized as an important respiratory pathogen. Serologic studies have shown antibody to TW\R in 25 to 45 percent of adults and evidence of acute infection in 6 to 12 percent of both outpatients and hospitalized patients with pneumonia in six different studies. C pneumoniae has generally been isolated from swabs of the posterior pharynx. The role of bronchoscopy and BAL in establishing a diagnosis of C pneumoniae infection has not been evaluated. We have occasionally recovered C pneumoniae in the BAL as sole pathogen in patients with pneumonia who have responded clinically and roentgenographically to single-agent narrow-spectrum antibiotic therapy (Dr. M. Rumbak, personal written communication, October, 1990). birth control yasmin
Microbiologic processing of BAL fluid for diagnosis of opportunistic or nonopportunistic pneumonias has not been standardized. We have implemented a laboratory protocol (Fig 1) adapted from methods used with immunosuppressed patients. Samples of BAL fluid are analyzed using a variety of microscopic, cultural, and nonculture-dependent methods to identify organisms causing pneumonia, including “atypical agents.” Key elements of this protocol are described below.
Figure 1. BAL evaluation in nonopportunistic pneumonia.
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