title: Isolation of mycobacteria in patients with pulmonary alveolar proteinosis.
abstract: Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by accumulation of proteinaceous material in the alveoli of affected individuals. Pulmonary infections appear to develop with increased frequency in these patients. The increased rate of infection has been attributed to immunologic aberrations, such as impaired alveolar macrophage function, particularly when uncommon pathogens are involved. Among those pathogens, Nocardia asteroides and Mycobacterium tuberculosis have appeared most often in case reports in the literature. Mycobacterium avium-intracellulare (MAI) has rarely been isolated in these patients. We report an unusually high incidence of MAI isolation from lavage fluid in 8 of 19 consecutive patients who underwent therapeutic lung lavage for relief of symptomatic PAP, and summarize the available literature on isolation of potential respiratory pathogens in PAP.
authors.affiliation: Division of Allergy, Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710.
authors.forename: L A
authors.initials: LA
authors.lastname: Witty
authors.forename: V F
authors.initials: VF
authors.lastname: Tapson
authors.forename: C A
authors.initials: CA
authors.lastname: Piantadosi
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D011649:Pulmonary Alveolar Proteinosis / Q000382:microbiology* / Q000503:physiopathology; D011653:Pulmonary Diffusing Capacity; D014109:Total Lung Capacity