[Kinetics of the local immune response in lobar pneumonia]

In 19 patients suffering from lobar pneumonia and treated with antibiotics, bronchoalveolar lavages were performed in attempt to follow the course of the biological disorders caused by the pulmonary bacterial infection. The cytologic study of the fluid harvested from 14 patients with normal immune reactivity showed, firstly, a polymorphonuclear leucocytosis and, after about ten days, a lymphocytosis, reaching 30 to 70% of the alveolar cell population. These cell disorders existed only in the lobe affected by the pneumonia process. In five alcoholics (one of them also splenectomized), the polymorphonuclear leucocytosis lasted 15 to 25 days and the lymphocytosis was delayed and moderate. We also searched for the pneumococcal antigen by counter-current immunoelectrophoresis using a polyvalent antiserum. We found it in 13 patients, 7 with a positive hemoculture for pneumococcus and 6 negatives. Clearance of this antigen was slow, non modified by alcoholism. We found this antigen in two patients later, between the 90th and 110th days, in the lavage fluid concentrated fifty times. The quantitative and qualitative study of the immunoglobulins revealed considerable individual variations, owing to the variable intensity of the local inflammation phenomenons and to the technical difficulties of their dosage in the lavage fluid.