[Broncho-alveolar lavage by fibroscopy in immunodepressed children].
Thirty broncho-alveolar lavage (BAL) were performed in order to investigate 30 infectious episodes in immunocompromised children. Twenty patients were previously treated by high-dose chemotherapy and autologous bone marrow transplantation and 6 other patients by conventional methods. A specific etiologic diagnosis was obtained in 16 of 30 episodes (56%), 22 microorganisms were identified by BAL. The most frequently involved microorganism was Candida albicans and the other agents were as follows: 3 cytomegalovirus, 2 Pneumococcus, 2 Pneumocystis carinii, 1 Aspergillosis, 1 syncytial respiratory virus, 1 myxovirus, 1 Pseudomonas aeruginosa, 1 Mycoplasma pneumoniae, 1 Haemophilus influenzae and 1 Escherichia coli. In 5 cases, more than 2 agents were involved. This study emphasizes the diagnostic interest of BAL for infectious diseases of the immunocompromised child. BAL appears to be a non invasive, rapid and reproducible method, and a useful therapeutic approach in the treatment of infectious episodes occurring in grafted children where several microorganisms could be involved at the same time.
Farge
A
A
Centre Léon-Bérard, Service de pédiatrie, Lyon, France.
Bellon
G
G
Bouffet
E
E
Biron
P
P
Cochat
P
P
Brunat-Mentigny
M
M
Floret
D
D
Philip
T
T
D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000209:etiology; D016026:Bone Marrow Transplantation; D001992:Bronchoalveolar Lavage Fluid / Q000473:pathology; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D008297:Male; D009181:Mycoses / Q000000981:diagnostic imaging / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D007507:Therapeutic Irrigation; D014182:Transplantation, Autologous; D014777:Virus Diseases / Q000000981:diagnostic imaging / Q000209:etiology
Lavage broncho-alvéolaire par fibroscopie chez l'enfant immunodéprimé.