Related Experiment Videos
Bronchoscopy in the diagnosis of pulmonary histoplasmosis
1Division of Thoracic Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Abstract:
Although histoplasmosis is the most common fungal infection of the lungs in the United States, there are no reports evaluating the efficacy of fiberoptic bronchoscopy in the diagnosis of this disease. We reviewed all cases of histoplasmosis diagnosed at our institution from 1972 to 1987. Of 469 patients, 71 underwent fiberoptic bronchoscopy and had culture/histologic proof of histoplasmosis established by fiberoptic bronchoscopy or other means. A diagnosis of pulmonary histoplasmosis could be made without thoracotomy in only 27. Among those not requiring thoracotomy, diagnosis of pulmonary histoplasmosis was confirmed by fiberoptic bronchoscopy and cultures of sputum, gastric washings, blood, bone marrow, and urine. In this subgroup, fiberoptic bronchoscopy was the only positive diagnostic method in eight of 27 patients. We conclude that fiberoptic bronchoscopy is a useful adjunct to other noninvasive measures yielding diagnostic material in most cases, except for solitary pulmonary nodule where it is rarely helpful.
Insights
Fiberoptic bronchoscopy aids in diagnosing pulmonary histoplasmosis when combined with other noninvasive methods. It proved to be the sole positive diagnostic tool in some patients, proving its utility.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical Diagnostics
Background:
- Histoplasmosis is the most common fungal lung infection in the US.
- No prior studies evaluated fiberoptic bronchoscopy for histoplasmosis diagnosis.
Purpose of the Study:
- To evaluate the efficacy of fiberoptic bronchoscopy in diagnosing pulmonary histoplasmosis.
Main Methods:
- Retrospective review of 469 histoplasmosis cases (1972-1987).
- Analysis of 71 patients who underwent fiberoptic bronchoscopy.
- Comparison of diagnostic yield with other methods like sputum and blood cultures.
Main Results:
- Fiberoptic bronchoscopy was the only positive diagnostic method in 8 of 27 patients not requiring thoracotomy.
- Diagnosis of pulmonary histoplasmosis was possible without thoracotomy in 27 patients.
- Fiberoptic bronchoscopy was rarely helpful for solitary pulmonary nodules.
Conclusions:
- Fiberoptic bronchoscopy is a valuable adjunct for diagnosing pulmonary histoplasmosis.
- It yields diagnostic material when used with other noninvasive measures.
- Its utility is limited in cases of solitary pulmonary nodules.