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Suspected Pneumocystis carinii pneumonia with a negative induced sputum examination. Is early bronchoscopy useful?
Am J Respir Crit Care Med. 1995 Jun; 151(6):1866-71.AJ

Abstract

In U.S. patients with the acquired immunodeficiency syndrome (AIDS), Pneumocystis carinii pneumonia is the most frequent AIDS-defining opportunistic infection. Sputum induction and bronchoscopy are effective techniques for obtaining specimens used to identify P. carinii although debate continues over their optimal use, specifically whether to perform bronchoscopy after a negative induced sputum examination for P. carinii. To evaluate the usefulness of bronchoscopy in this situation, we reviewed all cases of suspected P. carinii pneumonia in which sputum induction for P. carinii was performed at San Francisco General Hospital during a 4-yr period. Bronchoscopy, performed after a negative induced sputum examination, yielded a diagnosis in 50.5% of evaluations. The most frequent diagnoses were P. carinii pneumonia (192), tracheobronchial Kaposi's sarcoma (93), tuberculosis (28), and Cryptococcus neoformans pneumonia (9). Bronchoscopy provided either the only or an earlier diagnosis in 64.3% of tuberculosis cases. Bronchoscopy with BAL was free of complications, and, importantly, a negative BAL examination for P. carinii allowed physicians to discontinue empiric P. carinii pneumonia treatment in 95%. In patients with suspected P. carinii pneumonia with a negative induced sputum examination for P. carinii, early bronchoscopy with BAL should be performed.

Authors+Show Affiliations

Medicine Service, San Francisco General Hospital Medical Center, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7767533

Citation

Huang, L, et al. "Suspected Pneumocystis Carinii Pneumonia With a Negative Induced Sputum Examination. Is Early Bronchoscopy Useful?" American Journal of Respiratory and Critical Care Medicine, vol. 151, no. 6, 1995, pp. 1866-71.
Huang L, Hecht FM, Stansell JD, et al. Suspected Pneumocystis carinii pneumonia with a negative induced sputum examination. Is early bronchoscopy useful? Am J Respir Crit Care Med. 1995;151(6):1866-71.
Huang, L., Hecht, F. M., Stansell, J. D., Montanti, R., Hadley, W. K., & Hopewell, P. C. (1995). Suspected Pneumocystis carinii pneumonia with a negative induced sputum examination. Is early bronchoscopy useful? American Journal of Respiratory and Critical Care Medicine, 151(6), 1866-71.
Huang L, et al. Suspected Pneumocystis Carinii Pneumonia With a Negative Induced Sputum Examination. Is Early Bronchoscopy Useful. Am J Respir Crit Care Med. 1995;151(6):1866-71. PubMed PMID: 7767533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Suspected Pneumocystis carinii pneumonia with a negative induced sputum examination. Is early bronchoscopy useful? AU - Huang,L, AU - Hecht,F M, AU - Stansell,J D, AU - Montanti,R, AU - Hadley,W K, AU - Hopewell,P C, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 1866 EP - 71 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 151 IS - 6 N2 - In U.S. patients with the acquired immunodeficiency syndrome (AIDS), Pneumocystis carinii pneumonia is the most frequent AIDS-defining opportunistic infection. Sputum induction and bronchoscopy are effective techniques for obtaining specimens used to identify P. carinii although debate continues over their optimal use, specifically whether to perform bronchoscopy after a negative induced sputum examination for P. carinii. To evaluate the usefulness of bronchoscopy in this situation, we reviewed all cases of suspected P. carinii pneumonia in which sputum induction for P. carinii was performed at San Francisco General Hospital during a 4-yr period. Bronchoscopy, performed after a negative induced sputum examination, yielded a diagnosis in 50.5% of evaluations. The most frequent diagnoses were P. carinii pneumonia (192), tracheobronchial Kaposi's sarcoma (93), tuberculosis (28), and Cryptococcus neoformans pneumonia (9). Bronchoscopy provided either the only or an earlier diagnosis in 64.3% of tuberculosis cases. Bronchoscopy with BAL was free of complications, and, importantly, a negative BAL examination for P. carinii allowed physicians to discontinue empiric P. carinii pneumonia treatment in 95%. In patients with suspected P. carinii pneumonia with a negative induced sputum examination for P. carinii, early bronchoscopy with BAL should be performed. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/7767533/Suspected_Pneumocystis_carinii_pneumonia_with_a_negative_induced_sputum_examination__Is_early_bronchoscopy_useful L2 - https://www.atsjournals.org/doi/10.1164/ajrccm.151.6.7767533?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -