Opportunistic agents in bronchoalveolar lavage in 99 HIV seropositive patients.
During a ten month period, 117 fibreoptic bronchoscopies and bronchoalveolar lavages (BAL) were performed in human immunodeficiency virus (HIV) infected patients suspected of having opportunistic pulmonary infections. The BAL were classified into 3 groups, according to clinical manifestations related to HIV infection at the time of fibreoptic bronchoscopy: pre-acquired immunodeficiency syndrome (AIDS) (n = 54), AIDS with Kaposi's sarcoma (n = 37), AIDS without Kaposi's sarcoma (n = 26). On chest X-ray, diffuse infiltrates were most common (54%), followed by normal X-rays (24%) and localized infiltrates (18%). Amongst the 117 BAL, 68 (58%) yielded at least one opportunistic agent. In 28 BAL performed for pulmonary signs or unexplained fever with normal chest X-rays, one or several opportunistic agents were isolated in 17 samples of BAL fluid. The most frequently identified opportunistic agents were Pneumocystis carinii (in 38% of BAL) and cytomegalovirus (35%); these were associated in 17% of BAL. There was no statistically significant difference in opportunistic agents among the 3 groups of BAL (pre-AIDS, AIDS with Kaposi's sarcoma, AIDS without Kaposi's sarcoma). In particular, cytomegalovirus was found in BAL with the same frequency in these 3 groups.
Durand-Amat
S
S
Service de Pneumologie, Hôpital Saint-Louis, Paris, France.
Zalcman
G
G
Mazeron
M C
MC
Sarfati
C
C
Beauvais
B
B
Gerber
F
F
Pérol
Y
Y
Hirsch
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology; D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D001999:Bronchoscopy / Q000379:methods; D003371:Cough / Q000209:etiology; D003587:Cytomegalovirus / Q000302:isolation & purification*; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006679:HIV Seropositivity / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009159:Mycobacteriaceae / Q000302:isolation & purification; D009894:Opportunistic Infections / Q000150:complications* / Q000000981:diagnostic imaging; D011010:Pneumocystis / Q000302:isolation & purification*; D011859:Radiography; D012514:Sarcoma, Kaposi / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology; D018139:Simplexvirus / Q000302:isolation & purification