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Induced sputum versus bronchoalveolar lavage in the diagnosis of pneumocystis jiroveci pneumonia in human immunodeficiency virus-positive patients.
Braz J Infect Dis. 2007 Dec; 11(6):549-53.BJ

Abstract

Induced sputum is a useful technique for assessing airway inflammation, but its role in the diagnosis of lung disease in immunosuppressed patients needs further investigation. This study compared the use of induced sputum and BAL in the diagnosis of pneumocystosis, in HIV patients. From January 1, 2001, to December 30, 2002, HIV-positive patients older than 14 were evaluated at a hospital in Florianópolis, Santa Catarina, Brazil. Patients with respiratory symptoms for seven days or longer, with a normal or abnormal chest X-ray, and those without respiratory symptoms but with an abnormal chest X-ray, were included in the study. All patients were submitted to clinical, radiological and laboratory evaluation, after which induced sputum and bronchoscopy with bronchoalveolar lavage were carried out. The samples were subjected to the following techniques: Gram and Ziehl-Neelsen staining, quantitative culture growth for pyogenic bacteria, direct staining for fungi, culture growth for mycobacteria and fungi, and Grocott-Gomori staining for Pneumocystis jiroveci, as well as total and differential cell counts. The samples with P. jiroveci were selected, as well as the samples for which no etiologic agents were observed. Forty-five patients with a mean age of 34.6, 38 male and 40 Caucasian, comprised the subjects. Interstitial infiltrate was the most frequent radiological pattern (53.3%). The induced sputum sensitivity was 58.8%, specificity 81.8%, predictive positive value 90.9%, predictive negative value 39.1% and accuracy 64.4%, for the diagnosis of pneumocystosis, compared with BAL. Based on these data, induced sputum is a useful technique for the diagnosis of pneumocystosis in HIV patients.

Authors+Show Affiliations

University of South of Santa Catarina, Florianópolis, Brazil.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18327465

Citation

Silva, Rosemeri Maurici da, et al. "Induced Sputum Versus Bronchoalveolar Lavage in the Diagnosis of Pneumocystis Jiroveci Pneumonia in Human Immunodeficiency Virus-positive Patients." The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases, vol. 11, no. 6, 2007, pp. 549-53.
Silva RM, Bazzo ML, Borges AA. Induced sputum versus bronchoalveolar lavage in the diagnosis of pneumocystis jiroveci pneumonia in human immunodeficiency virus-positive patients. Braz J Infect Dis. 2007;11(6):549-53.
Silva, R. M., Bazzo, M. L., & Borges, A. A. (2007). Induced sputum versus bronchoalveolar lavage in the diagnosis of pneumocystis jiroveci pneumonia in human immunodeficiency virus-positive patients. The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases, 11(6), 549-53.
Silva RM, Bazzo ML, Borges AA. Induced Sputum Versus Bronchoalveolar Lavage in the Diagnosis of Pneumocystis Jiroveci Pneumonia in Human Immunodeficiency Virus-positive Patients. Braz J Infect Dis. 2007;11(6):549-53. PubMed PMID: 18327465.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Induced sputum versus bronchoalveolar lavage in the diagnosis of pneumocystis jiroveci pneumonia in human immunodeficiency virus-positive patients. AU - Silva,Rosemeri Maurici da, AU - Bazzo,Maria Luiza, AU - Borges,Alessandra Abel, PY - 2007/07/12/received PY - 2008/3/11/pubmed PY - 2008/6/11/medline PY - 2008/3/11/entrez SP - 549 EP - 53 JF - The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases JO - Braz J Infect Dis VL - 11 IS - 6 N2 - Induced sputum is a useful technique for assessing airway inflammation, but its role in the diagnosis of lung disease in immunosuppressed patients needs further investigation. This study compared the use of induced sputum and BAL in the diagnosis of pneumocystosis, in HIV patients. From January 1, 2001, to December 30, 2002, HIV-positive patients older than 14 were evaluated at a hospital in Florianópolis, Santa Catarina, Brazil. Patients with respiratory symptoms for seven days or longer, with a normal or abnormal chest X-ray, and those without respiratory symptoms but with an abnormal chest X-ray, were included in the study. All patients were submitted to clinical, radiological and laboratory evaluation, after which induced sputum and bronchoscopy with bronchoalveolar lavage were carried out. The samples were subjected to the following techniques: Gram and Ziehl-Neelsen staining, quantitative culture growth for pyogenic bacteria, direct staining for fungi, culture growth for mycobacteria and fungi, and Grocott-Gomori staining for Pneumocystis jiroveci, as well as total and differential cell counts. The samples with P. jiroveci were selected, as well as the samples for which no etiologic agents were observed. Forty-five patients with a mean age of 34.6, 38 male and 40 Caucasian, comprised the subjects. Interstitial infiltrate was the most frequent radiological pattern (53.3%). The induced sputum sensitivity was 58.8%, specificity 81.8%, predictive positive value 90.9%, predictive negative value 39.1% and accuracy 64.4%, for the diagnosis of pneumocystosis, compared with BAL. Based on these data, induced sputum is a useful technique for the diagnosis of pneumocystosis in HIV patients. SN - 1413-8670 UR - https://www.unboundmedicine.com/medline/citation/18327465/Induced_sputum_versus_bronchoalveolar_lavage_in_the_diagnosis_of_pneumocystis_jiroveci_pneumonia_in_human_immunodeficiency_virus_positive_patients_ DB - PRIME DP - Unbound Medicine ER -