RT Journal Article
SR Electronic
T1 Pneumococcal antigen detection in bronchoalveolar lavage fluid from patients with pneumonia.
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 872
OP 874
DO 10.1136/thx.49.9.872
VO 49
IS 9
A1 P Jiménez
A1 M Meneses
A1 F Saldías
A1 M Velásquez
YR 1994
UL http://thorax.bmj.com/content/49/9/872.abstract
AB BACKGROUND--Pneumococcal pneumonia can be diagnosed by the detection of capsular antigen in sputum, serum, pleural fluid, or urine using countercurrent immunoelectrophoresis and latex agglutination. In addition, quantitative cultures of bronchoalveolar lavage (BAL) fluid are also reliable for establishing the aetiology of pneumonia. This study investigated the value of rapid detection of pneumococcal antigen in BAL fluid from patients with pneumonia. METHODS--Pneumococcal antigen was detected by countercurrent immunoelectrophoresis and latex agglutination. Patients were grouped according to BAL quantitative culture results into pneumococcal pneumonia (n = 24), other known aetiology (n = 18), and unknown aetiology (n = 17). Thirteen patients with interstitial lung disease and without pneumonia served as a control group. RESULTS--In patients with pneumococcal pneumonia, antigen was detected by countercurrent immunoelectrophoresis in 50% and by latex agglutination in 54% of cases. In patients with pneumonia of unknown aetiology pneumococcal antigen was detected by latex agglutination in 53% of cases. Antigen was not detected in patients with pneumonia of other known aetiology or in control patients, yielding a specificity of 100%. CONCLUSIONS--In patients with pneumococcal pneumonia requiring fibreoptic bronchoscopy detection of pneumococcal antigen in BAL fluid may rapidly and accurately confirm the aetiology. Furthermore, in nearly half the cases of pneumonia of unknown aetiology antigen can be detected, suggesting that Streptococcus pneumoniae is a major causative agent in such patients.