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Images in neonatal medicine
Massive bacterial cell invasion and reactive type II pneumocytes in bronchoalveolar lavage fluid from a preterm neonate
  1. Jasper V Been1,
  2. Catharina F M Linssen2,
  3. J Freek van Iwaarden3,
  4. Luc J I Zimmermann3
  1. 1Department of Paediatrics, Research Institute Growth and Development (GROW), Maastricht University Hospital, Maastricht, the Netherlands
  2. 2Department of Medical Microbiology, Maastricht University Hospital, Maastricht, the Netherlands
  3. 3Department of Paediatrics, Research Institute Growth and Development (GROW), Maastricht University Hospital, Maastricht, the Netherlands
  1. Correspondence to:
    Jasper V Been
    Maastricht University Hospital, Department of Paediatrics, PO Box 5800, 6202 AZ Maastricht, the Netherlands; jbee{at}paed.azm.nl

https://doi.org/10.1136/adc.2006.108167

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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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    Footnotes

    • This work was funded in part by a ‘Profileringsfonds’ grant from the Maastricht University Hospital.

    • Competing interests: None.

    • The Medical Ethics Committee of the Maastricht University Hospital, Maastricht, the Netherlands, approved the study in which the patient was enrolled and bronchoalveolar lavage fluid was collected.