ABSTRACT
The systemic capillary leak syndrome is a rare condition, with a high mortality rate, characterised by recurrent episodes of generalized edema, with hemoconcentration and hypoproteinemia, associated with paraproteinemia. Pathophysiologically, this syndrome is caused by a sudden, reversible increase in capillary permeability, with a rapid shift of plasma from the intravascular to the extravascular compartment with subsequent hypovolemic shock. We report a new patient of this unusual condition, and we review its diagnostic and therapeutic aspects.
Subject(s)
Capillary Leak Syndrome , Capillary Leak Syndrome/diagnosis , Capillary Leak Syndrome/physiopathology , Capillary Leak Syndrome/therapy , Female , Humans , Middle AgedABSTRACT
The results of the quantitative culture of sputum samples from patients with bronchiectasis were compared with those obtained in the same samples with the detection of antibody-coated bacteria (ACB), in the acute phase of the disease (group I), after antibiotic therapy (group II), and in the phase of clinical stability (group III). In quantitative cultures at least one potentially pathogen species was isolated, at a concentration of greater than or equal to 10(6) colony forming units/ml in the 7 sputum samples from group I, in 4 of the 5 samples from group II, and in 10 of the 11 samples from group III. The immunofluorescence technique detected ACB in all samples from group I and group II, and in 10 of the 11 from group III. The sample from group III in which ACB were not detected was the same in which potentially pathogen organisms were not detected by culture.
Subject(s)
Antibodies, Bacterial/analysis , Bacteria/isolation & purification , Bronchiectasis/microbiology , Sputum/microbiology , Acute Disease , Adult , Anti-Bacterial Agents/therapeutic use , Bacteria/immunology , Bacteriological Techniques , HumansABSTRACT
In the present study an immunofluorescence technique detecting antibody-coated bacteria was evaluated. It was applied to the sputum of seven patients with bacteremic pneumococcal pneumonia to assess its diagnostic usefulness. We conclude that it is a valid, quick and easy technique which permits to differentiate between bacteria contaminating the sputum from those involved in the infection. This gives, therefore, a new value to the study of sputum. In our series the duration of the disease had no influence on the results, and the three antigammaglobulins used (anti-IgG, anti-IgA and anti-IgM) yielded the same results in each sample. Thus, we feel that the local pulmonary immune response was secondary in type.
