Diagnosis of Pneumocystis carinii pneumonia. Evaluation and interest of a new direct fluorescent monoclonal antibody stain.

Opportunist disease in immunocompromised patients and prematured babies, Pneumocystis carinii pneumonia was rare. It represents today inaugural manifestation of SIDA in 35-40 % of cases. The research of the parasite becomes a current analysis for a medical laboratory, Biological diagnosis is based on the show of the parasit in the sampling with classical coloration technics. The limits of these colorations have played a great part in the development of fluorescent monoclonal antibody stains. In this evaluation, we compared, on 100 bronchiolo-alveolar-lavage (BAL), the performances of a new direct fluorescent monoclonal antibody stain recently commercialized (Pneumo Cel IF test(R) B.M.D. Laboratories) with those of two classical colorations: May-Grunwald-Giemsa and Gomori-Grocott. Standard colorations revealed 18 positive cases while direct immunofluorescence technic revealed 20 cases of pneumocystosis. This new test has showed reliability, sensitivity and high specificity due to the utilisation of a monoclonal antibody. The preparation and the reading of the slides are rapid and easy. In spite of a very higher price, direct immunofluorescent should become a choice method for the majority of medical analysis laboratories, by reason of its qualities and the many advantages it offers in comparison with classical colorations.