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Bronchoalveolar lavage fluid was collected from a ventilated preterm neonate (gestational age 28 weeks; birth weight 490 g) on day 5, 7 and 11 as part of a study protocol. She was unexpectedly diagnosed as having pneumonia, despite treatment with amoxicillin and gentamicin. The first cytocentrifuge preparation revealed an extremely high number of bacteria and extensive cellular invasion (fig 1). The total cell count was 4.2×106 cells/ml, 70.3% of which contained intracellular bacteria (67.7% neutrophils; 2.6% macrophages). Coagulase-negative staphylococci (CONS) …
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