Pulmonary fibrosis (IPF) is a relatively uncommon disease, but as lung specialists at the Lung Disease Center, we see more of a cluster than a general practice office. I recently described two new drugs approved by the FDA to help in the control of this disease. IPF can be progressive and lead to untimely death. One fact about this disease process, which has recently been studied, is the relationship between infection and disease progression. It appears that patients with IPF have an increased bacterial load in the distal airways compared to normal individuals. We also know that active infection in patients with IPF is associated with higher morbidity (generalized sickness) and mortality (death).

These findings may lead to some additional approaches to help patients suffering from this progressive disease. In order to determine the amount and type of bacteria present in these patients something called a bronchoalveolar lavage (BAL) must be performed. This procedure is done with an instrument called a fiberoptic bronchoscope. The airways are washed out with a sterile solution and the fluid is then sent to the lab for culture. Once the organisms are identified we can test them against certain antibiotics and consider treatment. It is not yet known if routinely treating patients with IPF with antibiotics will alter the course of their disease. The cause for IPF is unknown, but much work and research are currently being used to try and come to some better understanding of this disease, which will hopefully lead to more effective treatment.