The impact of open lung biopsy on diffuse pulmonary infiltrates in patients with AIDS.
The evidence concerning open lung biopsy (OLB) for diffuse pulmonary infiltrates in patients with AIDS is limited. This study retrospectively evaluated the diagnostic and therapeutic yields of OLB compared with bronchoscopy for patients with AIDS with diffuse pulmonary infiltrate treated in the National Taiwan University Hospital from 1997 to 2004. There were 15 and 46 patients enrolled in the OLB and bronchoscopic groups in this study, respectively. As compared with the bronchoscopic group, patients from the OLB group had a higher chance of acquiring a specific diagnosis and possible change of therapy (73 vs 32.6% and 60 vs 21.7%, respectively; P < 0.05). There were two (13.3%) patients with prolonged air leak (greater than 7 days) in the OLB group, whereas four patients (8.7%) had procedure-related complications in the bronchoscopic group. There was no procedure-related mortality in the OLB group. This study demonstrated that OLB can be safely performed in select patients and provide a superior diagnostic and therapeutic benefit compared with bronchoscopy for diffuse pulmonary infiltrates in patients with AIDS. This procedure should be performed early in the clinical course to avoid irreversible clinical deterioration of the patients with severe illness.
Lee
Chao-Hsiang
CH
Department of Thoracic Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Lee
Jang-Ming
JM
Hung
Chien-Ching
CC
Huang
Pei-Ming
PM
Kuo
Shunn-Wen
SW
Hsu
Hsau-Hsun
HH
Chen
Jing-Shin
JS
Lee
Yung-Chie
YC
D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology*; D000328:Adult; D001706:Biopsy / Q000379:methods*; D001999:Bronchoscopy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000473:pathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy