Diagnosis of pulmonary infections in immunocompromised patients by fiber-optic bronchoscopy with bronchoalveolar lavage and serology
1996 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, Vol. 28, no 5, 479-485 p.Article in journal (Refereed) Published
Fiber-optic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) were performed on 67 occasions in 57 immunocompromised patients with symptoms consistent with pulmonary infection. Diagnosis was achieved more often in renal transplant patients than in patients with hematological malignancies (85% versus 28%). Culture (bacteria, virus, fungi), staining and microscopy (bacteria, fungi, Pneumocystis carinii (PC)) and antigen detection by indirect immunofluorescence (cytomegalovirus (CMV), respiratory viruses, PC, Legionella) were used for diagnosis. On 20 occasions transbronchial biopsies with histopathologic examination were performed. In addition, serology comprising the herpes group (HHV-6) and respiratory viruses was done. A microbial diagnosis was obtained on 45% of occasions. The most common pathogens found were CMV (31%) and PC (25%). On 22 (33%) occasions a rapid diagnosis of 1 or more microbial agents was obtained within 24 h by conventional staining or indirect immunofluorescence. The clinical relevance of findings of CMV, HHV-6, and Epstein-Barr virus in BAL by polymerase chain detection on 18, 6 and 3 occasions is discussed. On 4 occasions pathogenic bacteria were found. It was not possible to relate findings of coagulase-negative staphylococci, alpha-streptococci and Candida albicans to the pulmonary infection.
Place, publisher, year, edition, pages
1996. Vol. 28, no 5, 479-485 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-55589PubMedID: 8953678OAI: oai:DiVA.org:uu-55589DiVA: diva2:83497