Viruses and bacteria in bronchial samples from patients with primary hypogammaglobulinemia

Viruses and bacteria in bronchoalveolar lavage fluids, protected specimen b rush samples, and bronchial biopsies from 14 patients with primary hypogamm aglobulinemia (11 Patients with common variable immunodeficiency [CVID] and three patients with X-linked agammaglobulinemia [XLA]) were analyzed. At t he time of the study, the patients had no signs of acute respiratory infect ions, and no antibiotics were administered. In addition to routine bacteria l and viral cultures, polymerase chain reaction tests were used for the det ection of adenovirus, cytomegalovirus (CMV), herpes simplex virus 1, entero virus, rhinovirus, Borrelia burgdorferi, Chlamydia pneumoniae, Legionello s pp., Mycoplasma pneumoniae, Pneumocystis carinii, and Ureaplasma urealyticu m. Viruses (four adenoviruses, one CMV, and one rhinovirus) were detected i n four of the 11 (36%) CVID patients. No viruses were found in the three pa tients with XLA or in 13 control patients. Bacteria from the lower respirat ory tract were detected in nine of the 14 (64%) patients with hypogammaglob ulinemia and three of the 13 (23%) control patients. Haemophilus influenzae was the most prevalent bacterium (43%) in the hypogammaglobulinemia patien ts. The study shows that patients with CVID harbor viral and bacterial infe ctions in the lower respiratory tract, which may predispose to the developm ent of changes in the respiratory tract.