Dynamics in the content of the cytokines in the bronchoalveolar lavage fluid in rats after acute inhalation intoxication by clorine and pyrolysis products, containing hydrogen chloride

It is known that inhalation exposure to chlorine and hydrogen chloride leads to damage to the respiratory system up to the development of acute pulmonary edema in victims. No data on the mechanisms of development of pulmonary edema upon exposure to hydrogen chloride have been found in the available literature. The study was carried out on white outbred male rats, which were divided into 3 groups: Group I control; Group II animals were intoxicated with chlorine at a dose of 1.5 median lethal concentration (30 min); Group III animals were intoxicated with hydrogen chloride at a dose of 1.5 median lethal concentration (30 min). Immediately after exposure to the studied toxicants, as well as after 1, 3 and 6 h, the lung coefficient and the content of cytokines (interleukins-1, 6, 10 and interferon-) in the bronchoalveolar lavage fluid were determined in animals. It was revealed that an increase in the lung coefficient (p 0.05) in animals in groups II and III was accompanied by a significant increase (1.5 times) in the content of the studied cytokines in the bronchial-alveolar lavage fluid compared with animals in group I. III an increase (p 0.05) in the content of cytokines is recorded later only 3 hours after exposure, while it is significantly lower than in animals of group II at all studied periods. Thus, intoxication with hydrogen chloride leads to a slower development of pulmonary edema and an increase in the content of both pro (interleukins-1, 6) and anti-inflammatory cytokines (interleukin-10, interferon-) in the bronchial-alveolar lavage fluid compared to animals, exposed to chlorine intoxication.

Prognosis of lower respiratory tract infected patients with virus detected in bronchial alveolar lavage fluid: a retrospective observational study

Background and Objectives The influence of virus detected in BALF is still debating. This study aimed to compare the prognosis of lower respiratory tract infected patients with virus detected in bronchial alveolar lavage fluid (BALF) and patients with virus undetected by using metagenomic next-generation sequencing technology.Methods This was a retrospective cohort study. 53 patients with lower respiratory tract infection were enrolled. BALF samples were collected from each patient and sent to perform mNGS pathogenic test in the study. According to the results of mNGS test, patients were divided into virus-detected group and virus-undetected group. In the meanwhile, patients’ clinical information, medical history, disease severity scores, parameters of organ function at the day of ICU admission, prognosis, hospital length of stay, ICU length of stay and needs for medical support were also collected.Results 39.6 percent (21/53) of the BALF samples were virus nucleic acid positive. Mortality rate, tracheotomy rate, mechanical ventilation supporting time, blood transfusion rate were significantly higher in virus-detected group than that in virus-undetected group. Virus-detected was closely related to hospital and ICU survival time.Conclusions Patients with virus detected in BALF were prone to a poorer prognosis. The detection of virus was a high-risk factor of death for LRTI patients. Virus-detected patients required more medical resources.

Pulmonary Nocardiosis in Immunocompetent Patient: A Rare Case Report

Pulmonary nocardiosis is a rare bacterial infection that may lead to severe disease in immunodeficient patients and usually not so common in immunocompetent patients. The report is about a 57-year-old male with Norcardiosis. His sputum and Bronchial Alveolar Lavage (BAL) were negative for acid-fast bacilli. Nocardia species was isolated in BAL culture. He was started on Trimethoprim/Sulfamethoxazole and Clarithromycin, which was later continued for six months.

276. Detection of Rhizopus oryzae-Specific Antigen (RSA) in Serum and Bronchial Alveolar Lavage Is a Potential Early Diagnostic Marker in Mucormycosis by R. oryzae

Background The diagnosis of mucormycosis was made by the identification of an organism in the histopathology with culture confirmation. However, culture often yields no growth, and histopathological identification of organism with typical of mucorales is sometimes difficult. Therefore, a reliable new diagnostic tool is expected. We reported a novel Rhisopus-specific antigen (23kDa, named protein RSA) by screening with a signal sequence trap was detected at significantly higher concentrations in serum and in lung homogenates in the infected mice on day 4. And the results were suggested RSA was a possible diagnostic marker of mucormycosis (Sato K, et al. Medical Mycology, 2017, 55,713–719). Here, we examined whether the RSA was detected on early stage in sera and bronchial alveolar lavage (BAL) of infected mice. Methods We developed the ELISA Kit using monoclonal antibody for RSA. The mice were injected with cortisone acetate and cyclophosphamide, and R. oryzae was infected intratracheally. Mice sera and BAL was obtained from infected mice on day 1, 2, 3, and 4. Then the concentration of RSA in sera and BAL was evaluated using the ELISA Kit for RSA. Results The RSA was detected in sera and BAL on day 1, 2, 3, and 4. The concentration of RSA in sera and BAL were significantly higher on day 1 as compared with uninfected mice. And the concentration of RSA in sera was the upward trend through day 1 to 4. However, the concentration of RSA in BAL was stable through day 1 to 4. Conclusion The RSA is a potential early diagnostic marker in mucormycosis by R. oryzae. Disclosures All authors: No reported disclosures.