Hideaki Shigeno

Clinical and Bacteriological Evaluation of Branhamella catarrhalis in Respiratory Infections

SummaryThe clinical significance of Branhamella catarrhalis in respiratory infections is evaluated. 175 strains were isolated, mainly from the sputum, in 71 patients with respiratory infections. B. catarrhalis was most frequently isolated in mixed infections with Haemophilus influenzae (38.3%), H. influenzae plus Streptococcus pneumoniae (10.3%) or S. pneumoniae (9.7%). The rate of isolation of B. catarrhalis alone was as low as 5.1% and from mixed infections with Pseudomonas aeruginosa, Escherichia coli, and Enterobacter and/or Klebsiella species it was 36.6%. More than 107 cfu/ml of B. catarrhalis were isolated from 71.4% of cases.In 29 cases the organism was determined to be causative according to our criteria, most often in secondary infections in patients with complicated pneumoconiosis, chronic bronchitis and bronchiectasis.29 of 47 strains (61.7%) produced β-lactamase of the penicillinase type. Against these strains, penicillin antibiotics and first and second generation cephalosporin antibiotics (except cefroxadine) showed weak activity compared with their activity against non-β-lactamase- producing strains. The third generation cephalosporins showed a uniform spectrum of activity against both groups of organisms.

急性増悪を来したHTLV-I関連間質性肺炎の1例と気管支肺胞洗浄 (BAL) 所見

A 70-year-old male was admitted to our hospital because of fever and dyspnea. The patient was seropositive for HTLV-I and ATL cells were seen in the peripheral blood in the percentage of 2-5. The proviral DNA was positive and the diagnosis of smoldering ATL was made. His chest X-ray film showed diffuse reticulo-nodular infiltrates in both lung fields. The lung tissue obtained by transbronchial lung biopsy showed the lymphocytic infiltrations in the alveolar septa and the submucosa of the bronchioles. Bronchoalveolar lavage (BAL) fluid showed an increased proportion of lymphocytes that consisted mainly of CD3+ DR+ cells and the CD4+/CD8+ ratio was 2.1 during exacerbation and 0.8 after steroid therapy. Anti-HTLV-I IgG and IgA antibodies were positive in both serum and BAL fluid by Western blotting method. It is suggested that T-lymphocyte alveolitis may occur in patients who are seropositive for HTLV-I and the immunological mechanism seems to be responsible.