[Asthma and bacterial infections].

Known for many years, the relationship between bronchial asthma and bacteria are complex. Nevertheless they certainly are part of the several pathogenetic mechanisms of that disease. The recent discovery of specific IgE antibodies to several species of bacteria introduces new insights in the classification of these mechanisms. A careful consideration of the clinical symptoms remains a priority in analyzing the part played by bacteria in inducing bronchospasms. However, some laboratory procedures and especially the bronchial provocation tests with the specific antigen are of importance, bringing elements in accord with the immediate, late or delayed reaction. It is a basic requirement to have all these informations available to decide whether an hyposensitization therapy with bacterial extract is really needed. This will be done only in case of immediate type of reactions likely to be IgE mediated. Non specific polyvalent immunotherapy with a mixture of bacterial extract or derivates is sometimes indicated in cases of chronic infections of the upper and lower respiratory tract. Finally, some patients are reacting with an acute bronchospasm to minute doses of endotoxins. Therapy with bacterial extracts should be avoided in those patients.