Use of Fiberoptic Bronchoscopy and Bronchoalveolar Lavage in Immunocompromised Patients with Lung Infiltrates_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 ZHANG Pengyu , ZHANG Guoqing , XIE Guogang , JIN Xianqiao , ZHOU Xin.

Department of Respiratory Medicine, The First People’s Hospital, Shanghai Jiaotong University. Shanghai,200080, China;

Corresponding author：

ZHANG Pengyu, Email: zhangpengyu1505@yahoo.com.cn

Keywords：

Bronchoscopy; Bronchoalveolar lavage; Immunocompromised patients

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Objective To investigate the diagnostic value and complications of fibrobronchoscopy and bronchoalveolar lavage in immunocompromised patients with pulmonary infiltrates. Methods Fiberoptic bronchoscopy was performed in 31 immunocompromised patients. The clinical data and results of bronchoalveolar lavage were collected. In addition to conventional microbiological methods, molecular detection for cytomegalovirus( CMV) and respiratory viruses were performed. Results In all cases BAL was performed. The overall diagnostic yield of fibrobronchoscopy was 65% . The diagnosis was more likely to be established by fibrobronchoscopy when the lung infiltrate was due to an infectious agent( 86%) than to a noninfectious process( 25% ) . By molecular detection, CMV was identified in 4 cases, and other respiratory viruses were identified in 3 cases. Fever ( 23% ) was the most common complication. Conclusions Fibrobronchoscopy and BAL are effective and safe for the diagnosis of pulmonary infiltrates in immunocompromised patients. The molecular technique may help to enhance the diagnostic yield of BAL.

Citation： ZHANG Pengyu,ZHANG Guoqing,XIE Guogang,JIN Xianqiao,ZHOU Xin.. Use of Fiberoptic Bronchoscopy and Bronchoalveolar Lavage in Immunocompromised Patients with Lung Infiltrates. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(3): 259-261. doi: Copy

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1. Shorr AF, Kollef MH. The quick and the dead: the importance of rapid evaluation of infiltrates in the immunocompromised patient.Chest, 2002, 122: 9-12.
2. Jain P, Sandur S, Meli Y. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest, 2004 , 125 :712-722.
3. Hohenthal U, It　l　M, Salonen J. Bronchoalveolar lavage in immunocompromised patients with haematological malignancy--value of new microbiological methods. Eur J Haematol, 2005, 74: 203 -211.
4. Fan J, Henrickson KJ, Savatski LL. Rapid simultaneous diagnosis of infections with respiratory syncytial viruses A and B, influenza viruses A and B, and human parainfluenza virus types 1 , 2, and 3 by multiplex quantitative reverse transcription-polymerase chain reactionenzyme hybridization assay ( Hexaplex) . Clin Infect Dis, 1998, 26 :1397-1402.
5. Garbino J, Gerbase MW, Wunderli W. Lower respiratory viral illnesses: improved diagnosis by molecular methods and clinical impact. Am J Respir Crit Care Med, 2004, 170: 1197-1203.
6. 刘静, 王恒湘, 薛梅. 支气管镜及相关技术在骨髓移植术及化疗后肺部并发症病因诊断中的价值. 中华内科杂志, 2006, 45 : 849 -851.
7. 邓小梅, 谭星雨, 王金国, 等. 纤维支气管镜术后发热的临床特点. 中华结核和呼吸杂志, 2005, 28: 830-832.
8. 刘颖. 纤维支气管镜检查术后发热和感染的分析. 中国医师进修杂志, 2007, 30: 61-62.

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Use of Fiberoptic Bronchoscopy and Bronchoalveolar Lavage in Immunocompromised Patients with Lung Infiltrates

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