Tags

Type your tag names separated by a space and hit enter

Bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections.
Chest. 1991 Nov; 100(5):1272-6.Chest

Abstract

To further improve the diagnostic value of bronchoscopy in the immunosuppressed population presenting with diffuse pulmonary infiltrates, we prospectively investigated the utility of bilateral bronchoalveolar lavage (BAL). We performed 62 bronchoscopies on 52 immunosuppressed patients. Of the 52 patients, 33 had pulmonary infections. The yield for Pneumocystis carinii pneumonia on bilateral BAL was 94 percent (31/33), compared to the 84 percent (51/61) previously obtained with unilateral BAL in our institution. The recovery of P carinii was unilateral in four of five patients without AIDS and in four of 26 patients with AIDS. Transbronchial biopsy gave a yield of 85 percent (11/13). In ten patients with definitive cytomegalovirus (CMV) pneumonia, recovery of CMV by combined culture and cytology was 100 percent. Of nine bronchoscopies with positive cytology for CMV, five showed cytopathologic changes in the BAL from both sides and four in the BAL from one side only. No complications were seen in the 14 patients with thrombocytopenia or the five patients receiving mechanical ventilation. Our findings indicate that bilateral BAL significantly increases the yield for recovery of P carinii (p less than 0.02) and CMV (p less than 0.001) in immunosuppressed patients.

Authors+Show Affiliations

Meduri GU
Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical Center, New York, New York.
Stover DE
No affiliation info available
Greeno RA
No affiliation info available
Nash T
No affiliation info available
Zaman MB
No affiliation info available

MeSH

Acquired Immunodeficiency SyndromeAdultAgedBiopsyBronchiBronchoalveolar Lavage FluidBronchoscopyCytomegalovirus InfectionsFemaleHumansMaleMiddle AgedOpportunistic InfectionsPneumonia, PneumocystisPneumonia, ViralProspective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1657538

Citation

Meduri, G U., et al. "Bilateral Bronchoalveolar Lavage in the Diagnosis of Opportunistic Pulmonary Infections." Chest, vol. 100, no. 5, 1991, pp. 1272-6.
Meduri GU, Stover DE, Greeno RA, et al. Bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections. Chest. 1991;100(5):1272-6.
Meduri, G. U., Stover, D. E., Greeno, R. A., Nash, T., & Zaman, M. B. (1991). Bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections. Chest, 100(5), 1272-6.
Meduri GU, et al. Bilateral Bronchoalveolar Lavage in the Diagnosis of Opportunistic Pulmonary Infections. Chest. 1991;100(5):1272-6. PubMed PMID: 1657538.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections. AU - Meduri,G U, AU - Stover,D E, AU - Greeno,R A, AU - Nash,T, AU - Zaman,M B, PY - 1991/11/1/pubmed PY - 1991/11/1/medline PY - 1991/11/1/entrez SP - 1272 EP - 6 JF - Chest JO - Chest VL - 100 IS - 5 N2 - To further improve the diagnostic value of bronchoscopy in the immunosuppressed population presenting with diffuse pulmonary infiltrates, we prospectively investigated the utility of bilateral bronchoalveolar lavage (BAL). We performed 62 bronchoscopies on 52 immunosuppressed patients. Of the 52 patients, 33 had pulmonary infections. The yield for Pneumocystis carinii pneumonia on bilateral BAL was 94 percent (31/33), compared to the 84 percent (51/61) previously obtained with unilateral BAL in our institution. The recovery of P carinii was unilateral in four of five patients without AIDS and in four of 26 patients with AIDS. Transbronchial biopsy gave a yield of 85 percent (11/13). In ten patients with definitive cytomegalovirus (CMV) pneumonia, recovery of CMV by combined culture and cytology was 100 percent. Of nine bronchoscopies with positive cytology for CMV, five showed cytopathologic changes in the BAL from both sides and four in the BAL from one side only. No complications were seen in the 14 patients with thrombocytopenia or the five patients receiving mechanical ventilation. Our findings indicate that bilateral BAL significantly increases the yield for recovery of P carinii (p less than 0.02) and CMV (p less than 0.001) in immunosuppressed patients. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/1657538/Bilateral_bronchoalveolar_lavage_in_the_diagnosis_of_opportunistic_pulmonary_infections_ DB - PRIME DP - Unbound Medicine ER -