Use of bronchoalveolar lavage in immunocompromised children with pneumonia.
Because pneumonia in the immunocompromised host presents a diagnostic dilemma to the pediatrician, we prospectively studied the use of bronchoalveolar lavage (BAL) with flexible fiberoptic bronchoscopy in 14 immunocompromised children with pneumonia over a 5-month period. The children received immunosuppressive agents because of organ transplants, cancer, or systemic lupus erythematosus. A diagnosis was made by BAL in 10 (71%) of the 14 children. Pathogenic organisms included Pneumocystis carinii in six, cytomegalovirus (CMV) in two, Aspergillus fumigatus in one, and a mixed infection of Candida albicans and CMV in one. There were no complications. Because BAL by flexible fiber-optic bronchoscopy is a rapid and safe procedure and a diagnosis can be made in a majority of cases, we recommend its use in immunocompromised children with pneumonia before resorting to lung biopsy.
Pattishall
E N
EN
Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania 15213.
Noyes
B E
BE
Orenstein
D M
DM
D000293:Adolescent; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000382:microbiology; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D008297:Male; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology; D011014:Pneumonia / Q000175:diagnosis* / Q000276:immunology; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis; D011446:Prospective Studies