Prospective study of fever after bronchoalveolar lavage in children.
BACKGROUND
We investigated the significance of bronchoalveolar lavage fluid (BALF) characteristics and bacterial pathogens isolated in bronchoalveolar lavage fluids, oropharyngeal cultures and blood cultures for the development of fever in children after flexible bronchoscopy.


METHODS
We studied 41 consecutive patients (age 4 months to 15 years), who underwent bronchoalveolar lavage (BAL) and 24 hours temperature monitoring. Two blood cultures of each patient drawn at two sites, oropharyngeal swabs, total cell counts, cell differentials and microbial cultures from lavage fluid were studied.


RESULTS
Postbronchoscopic temperature increase was significantly higher in patients with positive BALF cultures (p = 0.04). Seven out of 41 patients had postbronchoscopic fever and positive bacterial cultures of BALF. Bacteraemia (with an identical pathogen isolated in BALF) was found in one febrile patient. There was a significantly higher total cell count (p = 0.03) and concentration of neutrophils (p = 0.001) in BALF among the children with presence of positive bacterial cultures.


CONCLUSIONS
We conclude that fever is a frequent adverse event following BAL in children and is rarely associated with bacteraemia. Findings associated with the risk to develop fever are positive bacterial cultures and high neutrophil numbers in BALF.
Hemmers
T
T
Klinik für Kinder- und Jugendmedizin, St. Josef Hospital, Ruhr-Universität Bochum.
Nüsslein
T
T
Teig
N
N
Rieger
C
C
Stephan
V
V
D000293:Adolescent; D001419:Bacteria / Q000302:isolation & purification; D001772:Blood Cell Count; D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000382:microbiology; D001999:Bronchoscopy / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D009504:Neutrophils; D009960:Oropharynx / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors