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Pneumocystis carinii pneumonia: detection of parasites in sputum and bronchoalveolar lavage fluid by monoclonal antibodies.
BMJ. 1988 Aug 06; 297(6645):381-4.BMJ

Abstract

Diagnosis of pneumocystis pneumonia is based on identifying Pneumocystis carinii cytochemically in material from the lung. The silver methenamine staining methods most commonly used are technically difficult and lack specificity. The diagnostic value of immunocytological identification of the parasite was evaluated by using mouse monoclonal antibody 3F6, specific for human pneumocystis, to identify P carinii in bronchoalveolar lavage fluid and sputum by immunofluorescence and was compared with that of other variables. Bronchoalveolar lavage was performed on 25 patients positive for HIV antibody with clinically suspected pneumocystis pneumonia and 40 patients negative for HIV antibody who presented with interstitial disorders of the lung. Lavage fluid showed pneumocystis only in the patients positive for antibody, the parasite being detected in 19 by immunofluorescence and in 17 by a modified silver methenamine staining method. Chest x ray films obtained at the time of bronchoscopy showed interstitial or alveolar shadowing in 17 of the 19 patients, but clinical symptoms and the presence of antibodies to pneumocystis did not seem to be predictive. Sputum samples were collected during 43 episodes of clinically suspected pneumocystis pneumonia in patients positive for HIV antibody. Pneumocystis was detected consistently more commonly by immunofluorescence than the silver strain in sputum collected routinely and induced by inhalation of saline. In 17 patients bronchoalveolar lavage followed sputum collection, and the sensitivity of detection of pneumocystis in immunofluorescence in sputum compared with lavage fluid was 57% (8/14). Immunofluorescence was suitable for specimens fixed in ethanol and seemed highly specific and more sensitive than the standard cytochemical methods for identifying pneumocystis.

Authors+Show Affiliations

Department of Parasitology, National Bacteriological Laboratory, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

3044514

Citation

Elvin, K M., et al. "Pneumocystis Carinii Pneumonia: Detection of Parasites in Sputum and Bronchoalveolar Lavage Fluid By Monoclonal Antibodies." BMJ (Clinical Research Ed.), vol. 297, no. 6645, 1988, pp. 381-4.
Elvin KM, Björkman A, Linder E, et al. Pneumocystis carinii pneumonia: detection of parasites in sputum and bronchoalveolar lavage fluid by monoclonal antibodies. BMJ. 1988;297(6645):381-4.
Elvin, K. M., Björkman, A., Linder, E., Heurlin, N., & Hjerpe, A. (1988). Pneumocystis carinii pneumonia: detection of parasites in sputum and bronchoalveolar lavage fluid by monoclonal antibodies. BMJ (Clinical Research Ed.), 297(6645), 381-4.
Elvin KM, et al. Pneumocystis Carinii Pneumonia: Detection of Parasites in Sputum and Bronchoalveolar Lavage Fluid By Monoclonal Antibodies. BMJ. 1988 Aug 6;297(6645):381-4. PubMed PMID: 3044514.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pneumocystis carinii pneumonia: detection of parasites in sputum and bronchoalveolar lavage fluid by monoclonal antibodies. AU - Elvin,K M, AU - Björkman,A, AU - Linder,E, AU - Heurlin,N, AU - Hjerpe,A, PY - 1988/8/6/pubmed PY - 1988/8/6/medline PY - 1988/8/6/entrez SP - 381 EP - 4 JF - BMJ (Clinical research ed.) JO - BMJ VL - 297 IS - 6645 N2 - Diagnosis of pneumocystis pneumonia is based on identifying Pneumocystis carinii cytochemically in material from the lung. The silver methenamine staining methods most commonly used are technically difficult and lack specificity. The diagnostic value of immunocytological identification of the parasite was evaluated by using mouse monoclonal antibody 3F6, specific for human pneumocystis, to identify P carinii in bronchoalveolar lavage fluid and sputum by immunofluorescence and was compared with that of other variables. Bronchoalveolar lavage was performed on 25 patients positive for HIV antibody with clinically suspected pneumocystis pneumonia and 40 patients negative for HIV antibody who presented with interstitial disorders of the lung. Lavage fluid showed pneumocystis only in the patients positive for antibody, the parasite being detected in 19 by immunofluorescence and in 17 by a modified silver methenamine staining method. Chest x ray films obtained at the time of bronchoscopy showed interstitial or alveolar shadowing in 17 of the 19 patients, but clinical symptoms and the presence of antibodies to pneumocystis did not seem to be predictive. Sputum samples were collected during 43 episodes of clinically suspected pneumocystis pneumonia in patients positive for HIV antibody. Pneumocystis was detected consistently more commonly by immunofluorescence than the silver strain in sputum collected routinely and induced by inhalation of saline. In 17 patients bronchoalveolar lavage followed sputum collection, and the sensitivity of detection of pneumocystis in immunofluorescence in sputum compared with lavage fluid was 57% (8/14). Immunofluorescence was suitable for specimens fixed in ethanol and seemed highly specific and more sensitive than the standard cytochemical methods for identifying pneumocystis. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/3044514/Pneumocystis_carinii_pneumonia:_detection_of_parasites_in_sputum_and_bronchoalveolar_lavage_fluid_by_monoclonal_antibodies_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/3044514/ DB - PRIME DP - Unbound Medicine ER -