[HIV-associated infections: indications and importance of fiberoptic bronchoscopy]

In 32 patients infected with HIV with unclear fever and/or pulmonary infiltraes, a fiberbronchoscopy (FB), with transbronchial lung biopsies (TBB) and bronchoalveolar lavage (BAL) was carried out. Thirteen of these patients had pneumocystis carinii pneumonia (PCP), three patients tuberculosis of the lungs, two patients pneumococcal pneumonia, and one patient each had a staphylococcal pneumonia, an enterobacter cloacae pneumonia, and an unspecific alveolitis. Thus, 66% of the patients proved diagnostically diagnosable by FB, so that appropriate therapy could be instituted. It proved possible to diagnose 77% of the PCP cases by TBB, and 62% by BAL. Thus, the combined use of both procedures increases the sensitivity of FB in detecting PCP. In two patients with PCP, no pulmonary infiltrations were to be seen. In no case was FB associated with any complications that required treatment. Through the additional use of other diagnostic procedures for identifying the organism, it proved possible to establish a total of 46 individual diagnoses. These results underscore the frequency of multiple infections in this group of patients.