[Fiber optics bronchoscopy yield and predictive clinical, analytical, and radiologic factors in the etiologic diagnosis of pulmonary pathology in patients with HIV infection].
The aim of this study was to assess the diagnostic performance of fibrobronchoscopy (FBS) in the pulmonary pathology of HIV-positive patients, in order to study the effect of several factors on such performance and to evaluate if these factors could guide the etiologic diagnosis. A retrospective study of 49 FBS with bronchoalveolar lavage (BAL) was performed in 44 HIV-positive patients. The diagnostic performance of FBS with BAL was 71.4%, with no significant modifications caused by previous prophylactic or empirical therapies, time of clinical evolution, radiological pattern, presence of hypoxemia or CD4 count. On the contrary, a high LDH was associated to a higher diagnostic performance.


METHODS
Pneumonia by Pneumocystis carinii (36.7%), M. tuberculosis (28.6%) and bacterial pneumonias (16.3%). The presence of biliary adenopathies, evolution longer than 1 week and pO2 > 80 mm Hg had a high sensitivity of 28.5% and a specificity of 97% for the diagnosis of tuberculosis, with a positive predictive value of 80% and a negative predictive value of 77.7%.
Supervía Caparrós
A
A
Servicio de Medicina Interna, Hospital de l'Esperança, Barcelona.
Mínguez Maso
S
S
Galofré Alvaro
N
N
Knobel Freud
H
H
Currull Serrano
V
V
Sanjuás Benito
C
C
D000328:Adult; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D055100:Optical Fibers; D011014:Pneumonia / Q000175:diagnosis / Q000209:etiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000209:etiology
Rendimiento de la fibrobroncoscopia y factores predictivos clínicos, analíticos y radiológicos en el diagnóstico etiológico de la patología pulmonar en pacientes con infección por VIH.