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[Broncho-alveolar lavage in HIV-1 seropositive children]
M Albertini1, T Bourrier, A Deville
1Clinique médicale infantile, hôpital de Cimiez, Nice, France.
Insights
Bronchoalveolar lavage (BAL) effectively diagnoses pulmonary infections in children with HIV. This method identified various pathogens and revealed latent abnormalities in asymptomatic patients, aiding in HIV diagnosis and management.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Immunology
Context:
- Children with HIV are susceptible to pulmonary infections.
- Diagnosing these infections can be challenging.
- Bronchoalveolar lavage (BAL) is a diagnostic procedure.
Purpose:
- To evaluate the utility of BAL in diagnosing pulmonary infections in children with HIV.
- To identify specific pathogens causing pulmonary disease in this population.
- To assess cytological findings in BAL fluid.
Summary:
- Sixteen BAL procedures were performed on 15 children with HIV.
- BAL identified 12 microorganisms in 5 cases of acute pneumonitis, including cytomegalovirus, respiratory syncytial virus, and Pneumocystis carinii.
- Cytological analysis revealed polymorphonuclear leukocytes in acute pneumonitis and alveolar lymphocytosis in asymptomatic cases.
Impact:
- BAL is a reliable tool for investigating pulmonary infections in HIV-positive children.
- It aids in identifying specific causative agents.
- BAL can detect latent cytological abnormalities, improving patient management.
Abstract:
Sixteen bronchoalveolar lavages (BAL) were performed in 15 children with HIV1 seropositivity, 12 of them being infected by HIV1. BAL was performed during episodes of acute pneumonitis with respiratory distress (group I: three cases) or without severity (group II: five cases), or in the presence of asymptomatic radiological pulmonary abnormalities (group III: seven cases). A specific diagnosis of infection was obtained in five cases of acute pneumonitis and 12 micro-organisms were identified by BAL: three cytomegaloviruses, three respiratory syncytial viruses, two Pneumocytis carinii, one Haemophilus influenzae, one Herpes simplex virus type 1, one Escherichia coli and one group A streptococcus. In three cases two micro-organisms were simultaneously identified. Cytological examination showed a high proportion of polymorphonuclear leukocytes in cases of acute pneumonitis (group II) and alveolar lymphocytosis in clinically asymptomatic children with radiological pulmonary abnormalities (group III). BAL appears to be a reliable tool for the investigation of pulmonary infections in children with HIV1 seropositivity. In addition it has the advantage of revealing latent cytological abnormalities in these patients.