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Asthma Management by Monitoring Sputum Neutrophil Count

*From the Firestone Institute for Respiratory Health and Department of Medicine (Ms. Pallan, Dr. O'Byrne, and Dr. Nair) and Department of Molecular Medicine (Dr. Mahony), McMaster University, Hamilton, ON, Canada.

Correspondence to: Parameswaran Nair, MD, PhD, FCCP, Firestone Institute for Respiratory Health, St. Joseph's Healthcare, Hamilton, ON, L8N4A6, Canada; e-mail: parames{at}mcmaster.ca

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.

Key Words: asthma • Chlamydophila pneumoniae • neutrophils • sputum cell counts

Abbreviations: IL, interleukin • PCR, polymerase chain reaction • TCC, total cell count

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