Role of Flexible Bronchoscopy and Bronchoalveolar Lavage in the Diagnosis of Pediatric Acquired Immunodeficiency Syndrome-Related Pulmonary Disease

Abstract

Flexible fiberoptic bronchoscopy with bronchoalveolar lavage was performed in 16 pediatric patients with the acquired immunodeficiency syndrome (AIDS) and deterioration in pulmonary function suggestive of opportunistic infection. In 62% of the patients Pneumocystis carinii was identified. Culture results showed a pure growth of Pseudomonas aeruginosa for one patient in addition to the Pneumocystis carinii. Bronchoscopy with lavage was well tolerated, with few complications even among patients with significant tachypnea and hypoxia. Because of its relative safety and effectiveness, this procedure should be considered the first invasive measurement used for evaluation of parenchymal lung disease in this population of patients.

Estimates of serious fungal infection burden in Côte d’Ivoire and country health profile

“…The relative infrequency of pneumocystosis is due to the low prevalence of Pneumocystis jirovecii in the African environment and lack of appropriate diagnostic means, such as bronchoalveolar lavage and trans-bronchial biopsy [53]. PCP may occur in other immunosuppression contexts, including solid organ transplant patients (kidney in particular), lymphoma or in patients receiving long-term corticosteroids.…”

Cellular and noncellular components of bronchoalveolar lavage fluid in HIV‐1‐infected children with radiological evidence of interstitial lung damage*

“…1 Flexible ®beroptic bronchoscopy with bronchoalveolar lavage (BAL) is a safe and effective method for diagnosing pulmonary infections in immunocompromised children. 2,3 Whereas BAL cellular results (lymphocytic or neutrophilic alveolitis) have a relatively low diagnostic yield in adults with AIDS-related pulmonary disease and in children, 4±9 BAL differential cell counts can reliably predict the outcome of patients with human immunode-®ciency virus type 1 (HIV-1) infections and pulmonary involvement. 10±13 For example, the ®nding of BAL neutrophilia in HIV-1-infected patients with opportunistic infections correlates strongly with an increased risk of death.…”

Study of bronchoalveolar lavage in HIV-infected children

“…Bronchoscopy with bronchoalveolar lavage (BAL) have been routinely used in the diagnostic approach of pulmonary complications caused by HIV-1. 1 , 2 …”

“…Infected patients present an increased susceptibility to pyogenic bacterial, viral, protozoal and mycobacterial infections and about 80% of them develop pulmonary disease more frequently and more severe. 1 , 2 …”

“…Opportunistic bacteria, mycobacteria, viruses and fungi are pathogens that can be isolated, especially Staphylococcus aureus , Streptococcus pneumoniae , Pseudomonas aeruginosa , Haemophilus influenzae , Pneumocystis jiroveci and Streptococcus viridans . 1 , 2 , 4…”