Bronchoalveolar Lavage for Diagnosis of Pneumonia in the Immunocompromised Child

Seven children with immunocompromised states were referred to the pediatric bronchoscopy service for evaluation of pneumonia. Flexible fiberoptic bronchoscopy accompanied with bronchoalveolar lavage was performed in all seven of these children. A definitive diagnosis was made for six of these seven patients. The diagnosis included Pneumocystis carinii in three, Candida albicans in two, and cytomegalovirus in one. There were no complications associated with the procedure. Flexible fiberoptic bronchoscopy with bronchoalveolar lavage should be considered early in the evaluation of the immunocompromised child with pneumonia.

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Role of Flexible Bronchoscopy and Bronchoalveolar Lavage in the Diagnosis of Pediatric Acquired Immunodeficiency Syndrome-Related Pulmonary Disease

PEDIATRICS ◽

10.1542/peds.87.6.897 ◽

1991 ◽

Vol 87 (6) ◽

pp. 897-899

Author(s):

Jose A. Birriel ◽

Jose A. Adams ◽

Kunjana Mavunda ◽

Sue Goldfinger ◽

Donald Vernon ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Acquired Immunodeficiency Syndrome ◽

Pneumocystis Carinii ◽

Fiberoptic Bronchoscopy ◽

Relative Safety ◽

Flexible Fiberoptic Bronchoscopy ◽

Acquired Immunodeficiency ◽

Immunodeficiency Syndrome ◽

Parenchymal Lung Disease

Flexible fiberoptic bronchoscopy with bronchoalveolar lavage was performed in 16 pediatric patients with the acquired immunodeficiency syndrome (AIDS) and deterioration in pulmonary function suggestive of opportunistic infection. In 62% of the patients Pneumocystis carinii was identified. Culture results showed a pure growth of Pseudomonas aeruginosa for one patient in addition to the Pneumocystis carinii. Bronchoscopy with lavage was well tolerated, with few complications even among patients with significant tachypnea and hypoxia. Because of its relative safety and effectiveness, this procedure should be considered the first invasive measurement used for evaluation of parenchymal lung disease in this population of patients.

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Experience With Flexible Fiberoptic Bronchoscopy With Bronchoalveolar Lavage as a Diagnostic Tool in Children With AIDS

Archives of Pediatrics and Adolescent Medicine ◽

10.1001/archpedi.1992.02160210058021 ◽

1992 ◽

Vol 146 (9) ◽

pp. 1056

Author(s):

Douglas L. Abadco

Keyword(s):

Bronchoalveolar Lavage ◽

Diagnostic Tool ◽

Fiberoptic Bronchoscopy ◽

Flexible Fiberoptic Bronchoscopy

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Effect of Bronchoalveolar Lavage on Gas Exchange in Patients with Diffuse Lung Disease and Respiratory Failure

Journal of Intensive Care Medicine ◽

10.1177/088506669200700304 ◽

1992 ◽

Vol 7 (3) ◽

pp. 149-153 ◽

Cited By ~ 2

Author(s):

Janet M. Shapiro ◽

Kathleen L. Pedersen ◽

Randolph P. Cole

Keyword(s):

Respiratory Failure ◽

Gas Exchange ◽

Bronchoalveolar Lavage ◽

Pneumocystis Carinii ◽

Ventilatory Support ◽

Fiberoptic Bronchoscopy ◽

Blood Gases ◽

Diffuse Lung Disease ◽

Arterial Blood ◽

Diffuse Lung

The effect of fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) on arterial oxygenation was examined in 22 patients with acute respiratory failure requiring mechanical ventilatory support. Arterial blood gases were determined immediately prior to BAL and at 15, 60, 120, and 360 minutes following BAL. PaO2/FIO2 decreased at 15 minutes and continued to decrease to approximately 33% below the baseline value at 2 hours. PaO2/FIO2 then remained constant over the remainder of the 6-hour study period. No substantial changes in FIO2, level of positive end-expiratory pressure, or intravenous pressor requirements occurred during the period of observation. Patients with lower pre-BAL PaO2/FIO2 ratios showed the least reduction in PaO2/FiO2 following BAL The BAL was diagnostic in 9 of 22 (41%) patients ( Pneumocystis carinii pneumonia in 5, bacterial pneumonitis in 2, and neoplastic involvement of the lung in 2). BAL was associated with mild deterioration of gas exchange but did not require significant changes in ventilatory or hemodynamic support for the 6-hour interval studied.

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Comparative morphology of Pneumocystis Carinii in Situ and after bronchoalveolar lavage

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100142840 ◽

1986 ◽

Vol 44 ◽

pp. 244-245

Author(s):

C. A. Itatani ◽

A. Hing ◽

W. Jackson ◽

G.J. Marshall

Keyword(s):

Bronchoalveolar Lavage ◽

Pneumocystis Carinii ◽

Comparative Morphology

Pneumocystis carinii (PC) is an organism capable of causing fatal pneumonia in immune suppressed individuals and has recently gained prominence because of its association with AIDS. A similar organism occurs in rats and infection may be induced with cortisone injections. In order to isolate PC for further study bronchoal veol ar lavage (BAL) was performed. Differences in the ul trastructure of BAL-obtained organisms and PC in situ were observed and are herein reported.

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