scholarly journals Cellular Profiles of Bronchoalveolar Lavage Fluid and Their Prognostic Significance for Non-HIV-Infected Patients with Pneumocystis jirovecii Pneumonia

2015 ◽  
Vol 53 (4) ◽  
pp. 1310-1316 ◽  
Author(s):  
Ju Young Lee ◽  
Hyun Jung Park ◽  
Yong Kyun Kim ◽  
Shinae Yu ◽  
Yong Pil Chong ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Lavage Fluid ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Care Hospital ◽  
Median Percentage ◽  
Content Type ◽  
Cellular Analysis

The usefulness of bronchoalveolar lavage (BAL) fluid cellular analysis in non-human immunodeficiency virus (HIV)-infected patients withPneumocystis jiroveciipneumonia (PCP) has not been adequately evaluated. The objective of this study was to analyze the cellular profiles of BAL fluid and to evaluate their prognostic significance in non-HIV-infected patients with PCP. A 7-year retrospective cohort study of 166 non-HIV-infected adult patients with PCP who underwent BAL was performed in a tertiary care hospital. The median total BAL fluid white blood cell count was 180/μl (interquartile range, 80 to 330) and was unaffected by the severity of PCP. The median percentages of BAL fluid neutrophils, lymphocytes, and alveolar macrophages were 13.1%, 31.7%, and 30.2%, respectively. The median percentage of BAL fluid neutrophils was significantly higher in severe than in mild-to-moderate PCP (20.4% versus 6.0%,P< 0.001), as was the absolute neutrophil count (24/μl versus 13/μl,P= 0.001). The percentage of BAL fluid neutrophils was an independent predictor of 30-day (adjusted odds ratio [aOR], 1.02; 95% confidence interval [CI], 1.01 to 1.03) and 60-day (aOR, 1.02; 95% CI, 1.01 to 1.04) mortalities. The 30-day and 60-day mortalities increased at rates of 15% (P= 0.006) and 21% (P< 0.001) per 10% increment of BAL fluid neutrophil levels, respectively. The degree of BAL fluid pleocytosis was relatively low without regard to the severity of PCP. The percentage of BAL fluid neutrophils can be used as a prognostic marker in non-HIV-infected patients with PCP.

scholarly journals Diagnostic Performance of Bronchoalveolar Lavage (1,3)-β-d-Glucan Assay for Pneumocystis jirovecii Pneumonia

2020 ◽  
Vol 6 (4) ◽  
pp. 200
Author(s):  
Shiwei Zhou ◽  
Kathleen A. Linder ◽  
Carol A. Kauffman ◽  
Blair J. Richards ◽  
Steve Kleiboeker ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Test Performance ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Lavage Fluid ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Characteristic Area

We evaluated the performance of the (1,3)-β-d-glucan (BDG) assay on bronchoalveolar lavage fluid (BALF) as a possible aid to the diagnosis of Pneumocystis jirovecii pneumonia. BALF samples from 18 patients with well-characterized proven, probable, and possible Pneumocystis pneumonia and 18 well-matched controls were tested. We found that the best test performance was observed with a cut-off value of 128 pg/mL; receiver operating characteristic/area under the curve (ROC/AUC) was 0.70 (95% CI 0.52–0.87). Sensitivity and specificity were 78% and 56%, respectively; positive predictive value was 64%, and negative predictive value was 71%. The low specificity that we noted limits the utility of BALF BDG as a diagnostic tool for Pneumocystis pneumonia.

scholarly journals De Novo Assembly of the Pneumocystis jirovecii Genome from a Single Bronchoalveolar Lavage Fluid Specimen from a Patient

mBio ◽  
2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Ousmane H. Cissé ◽  
Marco Pagni ◽  
Philippe M. Hauser
Keyword(s):  
Bronchoalveolar Lavage ◽  
Genome Sequence ◽  
Bronchoalveolar Lavage Fluid ◽  
De Novo ◽  
Gc Content ◽  
Lavage Fluid ◽  
New Drugs ◽  
Pneumocystis Jirovecii ◽  
Content Type

ABSTRACTPneumocystis jiroveciiis a fungus that causes severe pneumonia in immunocompromised patients. However, its study is hindered by the lack of anin vitroculture method. We report here the genome ofP. jiroveciithat was obtained from a single bronchoalveolar lavage fluid specimen from a patient. The major challenge was thein silicosorting of the reads from a mixture representing the different organisms of the lung microbiome. This genome lacks virulence factors and most amino acid biosynthesis enzymes and presents reduced GC content and size. Together with epidemiological observations, these features suggest thatP. jiroveciiis an obligate parasite specialized in the colonization of human lungs, which causes disease only in immune-deficient individuals. This genome sequence will boost research on this deadly pathogen.IMPORTANCEPneumocystispneumonia is a major cause of mortality in patients with impaired immune systems. The availability of theP. jiroveciigenome sequence allows new analyses to be performed which open avenues to solve critical issues for this deadly human disease. The most important ones are (i) identification of nutritional supplements for development of culturein vitro, which is still lacking 100 years after discovery of the pathogen; (ii) identification of new targets for development of new drugs, given the paucity of present treatments and emerging resistance; and (iii) identification of targets for development of vaccines.

scholarly journals Role of PCR for diagnosing Pneumocystis jirovecii pneumonia in HIV-infected individuals in a tertiary care hospital in India

2011 ◽  
Vol 54 (2) ◽  
pp. 326 ◽  
Author(s):  
Kiran Chawla ◽  
Suganthi Martena ◽  
Bimala Gurung ◽  
Chiranjay Mukhopadhyay ◽  
GeorgeK Varghese ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Care Hospital

scholarly journals Detection of Pneumocystis jirovecii in Patients with Severe COVID-19: Diagnostic and Therapeutic Challenges

2021 ◽  
Vol 7 (8) ◽  
pp. 585
Author(s):  
Victor Gerber ◽  
Yvon Ruch ◽  
Thiên-Nga Chamaraux-Tran ◽  
Walid Oulehri ◽  
Francis Schneider ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Mechanical Ventilation ◽  
Hospital Admission ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Tracheal Aspirate ◽  
Lavage Fluid ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Risk Patients

Cases of Pneumocystis jirovecii pneumonia (PCP) in patients suffering from COVID-19 were described in patients with various comorbidities and outcomes. The diagnosis of PCP in these patients is difficult due to clinical and radiological similarities. We carried out this study in order to better describe potentially at-risk patients and their outcomes. We retrospectively analyzed all patients with a P. jirovecii PCR performed in bronchoalveolar lavage fluid, tracheal aspirate, or sputum within a month after the COVID-19 diagnosis. Fifty-seven patients with COVID-19 infection were tested for P. jirovecii. Among 57 patients with COVID-19, four patients had a concomitant positive P. jirovecii PCR. These four patients were elderly with a mean age of 78. Two patients were immunocompromised, and the two others presented only diabetes mellitus. Three patients presented an ARDS requiring transfer to the ICU and mechanical ventilation. All patients presented lymphocytopenia. Three patients had probable PCP, and one had proven PCP. All patients died within two months after hospital admission. These co-infections are rare but severe, therefore, PCP should be considered in case of worsening of the condition of patients with severe COVID-19.

scholarly journals 747. Diagnostic Performance of Bronchoalveolar Lavage Fluid Galactomannan Assay in Patients with Negative Serum Galactomannan Assay Suspected with Invasive Pulmonary Aspergillosis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S421-S421
Author(s):  
So Yun Lim ◽  
Jinyeong Kim ◽  
Sunghee Park ◽  
Jiwon Jung ◽  
Min Jae Kim ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Diagnostic Performance ◽  
Bronchoalveolar Lavage Fluid ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Invasive Pulmonary Aspergillosis ◽  
Lavage Fluid ◽  
Fungal Culture ◽  
Care Hospital ◽  
Pulmonary Aspergillosis

Abstract Background There are limited data in real clinical practice on the diagnostic value of BAL (bronchoalveolar lavage) fluid galactomannan (GM) assay in patients with suspected invasive pulmonary aspergillosis (IPA) who had negative serum GM results. Methods This study was performed at Asan Medical Center, a 2700 bed tertiary-care hospital in Seoul, South Korea between May 2008 and April 2019. All patients with suspected IPA whose serum GM assays revealed negative results and sequentially underwent BAL were enrolled in this study. Patients were classified as proven, probable, possible or not IPA by the revised 2019 EORTC/MSG definition. Results A total of 341 patients with suspected IPA including 4 proven IPA, 38 probable IPA, 107 possible IPA, and 192 not IPA were enrolled. Of these 341 patients, 107 (31%) with possible IPA were excluded from the final analysis. Of 42 patients with proven or probable IPA who had initial negative serum GM results, 24 (57%) revealed positive BAL GM results (n=24) or BAL fungal culture (n=8). Among the remaining 18 (43%), 2 (5%) were diagnosed as proven IPA by the histopathologic exam from transbronchial lung biopsy, 6 (14%) as probable IPA by subsequent sputum fungal culture, and 10 (24%) as probable IPA by repeated serum GM assay after BAL. Of 192 patients with not IPA, 14 (7%) revealed positive BAL GM results (n=14) or BAL fungal culture (n=8). The diagnostic performance of various tests is shown in Table 1. Table 1. Diagnostic performance of various diagnostic tests in patients with suspected IPA who had negative serum GM results Conclusion Sequential BAL in patients with suspected IPA who had initial negative serum GM results provided additional diagnostic yield in about half of patients. Disclosures All Authors: No reported disclosures

Sign in / Sign up

Export Citation Format

Share Document