Experience with flexible fiberoptic bronchoscopy with bronchoalveolar lavage as a diagnostic tool in children with AIDS
D. L. Abadco, R. Amaro-Galvez, M. Rao and P. Steiner
Division of Pediatric Pulmonology, Children's Medical Center of Brooklyn, NY.
OBJECTIVE--To report our experience with flexible fiberoptic bronchoscopy
with bronchoalveolar lavage in children with the acquired immunodeficiency
syndrome and acute lower respiratory tract disease. DESIGN--Retrospective
study. SETTING--Children's Medical Center of Brooklyn, NY, a tertiary-level
inner-city hospital. PARTICIPANTS--Eighty-five children with acquired
immunodeficiency syndrome and acute lower respiratory tract disease.
INTERVENTION--One hundred five flexible fiberoptic bronchoscopies with
bronchoalveolar lavages. MEASUREMENTS/MAIN RESULTS--Infective agents were
recovered in 88 procedures (84%). Potentially pathogenic bacteria were
identified in 56 (56.6%) of 99 procedures. Viruses were found in 28 (29%)
of 96 lavages, and fungi in 37 (41.6%) of 89 specimens. Pneumocystis
carinii was identified in 22 (22.2%) of 99 specimens. Mycobacteria were
isolated from 14 (14%) of 100 specimens. A serious complication occurred in
only one procedure (0.95%). CONCLUSION--Flexible fiberoptic bronchoscopy
with bronchoalveolar lavage is a safe and effective diagnostic procedure
that identified infective agents in 80% of children with acquired
immunodeficiency syndrome and concomitant acute lower respiratory tract
disease.
