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Experience with flexible fiberoptic bronchoscopy with bronchoalveolar lavage as a diagnostic tool in children with
D L Abadco1, R Amaro-Galvez, M Rao
1Division of Pediatric Pulmonology, Children's Medical Center of Brooklyn, NY.
Insights
Flexible fiberoptic bronchoscopy with bronchoalveolar lavage is a safe and effective diagnostic tool for children with acquired immunodeficiency syndrome (AIDS) and acute lower respiratory tract disease. This procedure successfully identified infectious agents in 80% of cases, aiding in diagnosis and treatment.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Children with acquired immunodeficiency syndrome (AIDS) are susceptible to acute lower respiratory tract diseases.
- Accurate diagnosis is crucial for effective management of respiratory infections in immunocompromised children.
Purpose of the Study:
- To evaluate the safety and efficacy of flexible fiberoptic bronchoscopy with bronchoalveolar lavage (FOB-BAL) in pediatric patients with AIDS and respiratory illness.
- To determine the spectrum of infectious agents identified by FOB-BAL in this population.
Main Methods:
- Retrospective study of 105 FOB-BAL procedures performed on 85 children with AIDS and acute lower respiratory tract disease.
- Data collected on diagnostic yield, identified pathogens, and procedure-related complications.
Main Results:
- Infectious agents were identified in 84% of procedures.
- Commonly identified pathogens included bacteria (56.6%), fungi (41.6%), viruses (29%), Pneumocystis carinii (22.2%), and mycobacteria (14%).
- Serious complications occurred in only 0.95% of procedures, indicating a high safety profile.
Conclusions:
- Flexible fiberoptic bronchoscopy with bronchoalveolar lavage is a safe and effective method for diagnosing infectious causes of acute lower respiratory tract disease in children with AIDS.
- The procedure has a high diagnostic yield, identifying a wide range of pathogens.
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.