Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
Utility of Gomori methenamine silver stains in bronchoalveolar lavage specimens.
Mod Pathol. 1994 Jun;7(5):599-604. Unique Identifier : AIDSLINE MED/95023863 Raab SS; Cheville JC; Bottles K; Cohen MB; Department of Pathology, University of Iowa, Iowa City.
Abstract:
Bronchoalveolar lavage (BAL) with Gomori methenamine silver (GMS) stain is commonly used to detect Pneumocystis carinii and fungal organisms as causes of infectious pulmonic disease in immunosuppressed patients. However, several reports have indicated that GMS stains are not any more sensitive than conventional cytologic stains in detecting Pneumocystis organisms in select patient populations, such as those with acquired immunodeficiency syndrome (AIDS). To examine the utility of GMS stains in our laboratory, we retrospectively reviewed 243 BALs from 188 patients. Sensitivity of the GMS stain for Pneumocystis and for fungi detection was 100%. Sensitivity for Pneumocystis and for fungi detection by Papanicolaou stain alone was 79% and 88%, respectively; by Diff-Quik stain alone it was 68% and 88%, respectively; and by combined Papanicolaou and Diff-Quik stains it was 79% and 100%, respectively. In four additional cases, fungi were detected by other methods (culture, biopsy) and not by BAL. The GMS stain result was correlated with a number of risk variables to determine which variables were associated with GMS positivity. Using stepwise logistic regression, Pneumocystis positivity by GMS stain correlated (P < 0.0001) only with the variable of history of AIDS or AIDS risk factors. Fungal organism positivity by GMS stain correlated (P = 0.02) only with the variable of history of BAL positivity for fungus. Cost savings analyses were performed, estimating the cost of the GMS stain at $45 (total cost of GMS in 243 BALs was $10,935).(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords: Adolescence Adult Aged Aged, 80 and over Bronchoalveolar Lavage Fluid/*MICROBIOLOGY Child Child, Preschool Female Fungi/*ISOLATION & PURIF Human Infant Male *Methenamine/ECONOMICS Middle Age Pneumocystis carinii/*ISOLATION & PURIF Sensitivity and Specificity Staining/ECONOMICS/*METHODS Support, Non-U.S. Gov't JOURNAL ARTICLE 950130
M9510028
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
