title: Asthma management by monitoring sputum neutrophil count.
abstract: We report the utility of quantitative cell counts in sputum in monitoring therapy of a patient with poorly controlled asthma. Recurrent neutrophilic bronchitis without an eosinophilic bronchitis led to the identification of Chlamydophila pneumoniae as the cause of bronchitis and asthma exacerbation. Serial examination of blood and sputum by polymerase chain reaction for C pneumoniae helped to prevent exacerbations by prophylactic antibiotic therapy, reduce the dose of prednisone and inhaled corticosteroids, and improve asthma control.
authors.affiliation: Firestone Institute for Respiratory Health and Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Shelley
authors.initials: S
authors.lastname: Pallan
authors.affiliation: Department of Molecular Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: James B
authors.initials: JB
authors.lastname: Mahony
authors.affiliation: Firestone Institute for Respiratory Health and Department of Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: Paul M
authors.initials: PM
authors.lastname: O'Byrne
authors.affiliation: Firestone Institute for Respiratory Health and Department of Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: parames@mcmaster.ca.
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Nair
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology*; D001991:Bronchitis / Q000175:diagnosis / Q000473:pathology; D023521:Chlamydophila Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D016993:Chlamydophila pneumoniae; D005260:Female; D006801:Humans; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D012008:Recurrence; D013183:Sputum / Q000166:cytology*
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents