Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
Diagnosis of pulmonary disease in acquired immune deficiency syndrome (AIDS). Role of bronchoscopy and bronchoalveolar lavage.
Am Rev Respir Dis. 1984 Oct;130(4):659-62. Unique Identifier : AIDSLINE MED/85020899 Stover DE; White DA; Romano PA; Gellene RA
Abstract:
The effectiveness of fiberoptic bronchoscopy with the addition of bronchoalveolar lavage (BAL) was evaluated in 72 patients with the acquired immune deficiency syndrome (AIDS) and parenchymal pulmonary disease. The diagnostic yield varied for different pathogens and was 94% (45/48 cases) for Pneumocystis carinii, 67% (14/21 cases) for cytomegalovirus, and 62% (8/13 cases) for Mycobacterium avium intracellulare. Of the 11 cases of documented Kaposi's sarcoma in the lung parenchyma, none were diagnosed from bronchoscopy, although characteristic endobronchial lesions were seen in 6 cases. Overall, the yield of bronchoscopy for all pathogens was 65%. Both transbronchial biopsy and BAL had high independent yields (88 and 85%, respectively) for diagnosing P. carinii pneumonia but combining the procedures gave the best yield. Cytomegalovirus was most often diagnosed from examination and culture of the BAL. Recovery of Mycobacterium avium intracellulare was highest with culture of both washings and lavage. Neither granuloma nor organisms were seen on examination of histologic specimens. Bronchoscopy with BAL was well tolerated with few complications even in 5 patients with thrombocytopenia and 10 patients requiring mechanical ventilation. Sixteen patients (22%) had an increase in temperature after the procedure without hypotension or sepsis and 1 patient (1.5%) had a moderate pulmonary hemorrhage after transbronchial biopsy. Fiberoptic bronchoscopy with BAL is a safe procedure with a high diagnostic yield in AIDS patient with lung disease.
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Bronchi/PATHOLOGY *Bronchoscopy/ADVERSE EFFECTS/METHODS Cytomegalovirus Infections/MICROBIOLOGY Female Fiber Optics Human *Irrigation Lung Diseases/COMPLICATIONS/*PATHOLOGY Lung Neoplasms/PATHOLOGY Male Middle Age Mycobacterium Infections, Atypical/MICROBIOLOGY Pneumonia, Pneumocystis carinii/PARASITOLOGY Pulmonary Alveoli/PATHOLOGY Sarcoma, Kaposi's/PATHOLOGY JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
