Comparison of bronchoalveolar lavage cell findings in complete-resolution pneumonia and delayed-resolution pneumonia

Background: In some patients with bacterial pneumonia, the resolution of ch est radiograph shadows are delayed, There have been many clinical and patho logical studies on delayed-resolution pneumonia (DR), However, there are no reports concerning inflammatory cell findings of bronchoalveolar lavage (B AL) fluid in patients with DR. We compared the BAL fluid cell findings in p atients with DR with those in patients with complete-resolution pneumonia ( CR), Methods: The subjects included six patients whose chest radiograph shadows were completely resolved within 2 weeks after an appropriate antibiotic adm inistration (CR), and nine patients whose chest radiograph shadows were unr esolved more than 2 weeks after the treatment (DR), BAL was done 2-3 weeks after the antibiotic treatment in both groups. We compared differential cou nts and lymphocyte subsets in BAL fluid among patients with CR, patients wi th DR, and asymptomatic subjects, Results: There were no significant differences in BAL fluid cell findings b etween CR groups and asymptomatic groups,On the other hand, the percentages of lymphocytes, neutrophils and eosinophils in DR group were significantly increased compared with those in CR and normal groups. There was no signif icant difference in the CD4+/CD8+ ratio of BAL lymphocytes among the three groups. Conclusions: It is suggested that infiltration of inflammatory cells in the lung exists in DR, despite the disappearance of inflammatory reaction in t he peripheral blood.