title: [Cancer, febrile neutropenia and pulmonary images: Findings in bronchoalveolar lavage in children].
abstract: BACKGROUND
  Lung infections are a serious complication in children with cancer. Bronchoalveolar lavage (BAL) has been demonstrated to be an effective procedure for achieving etiologic diagnosis.
  
  
  METHODS
  We did a retrospective analysis of BAL data performed between November 2005 and October 2008 in children with cancer, severe neutropenia and lung infiltrates for assessing its performance, clinical utility and safety. Thirty-seven BAL were evaluated in 35 patients.
  
  
  RESULTS
  Focal infiltrates were demonstrated in imaging studies associated with 19/37 BAL; in 8 an infectious agent was found. Interstitial pattern was observed in 15/37, in which there were 4 positive studies, proving a higher microbiological performance in BAL associated with focal lesions. BAL yielded significant microbiological findings in 32.4% (12/37). Sixteen microorganisms were identified in the study: bacteria in 8 cases, Mycobacterium tuberculosis (n: 2), Pseudomonas aeruginosa (n: 2), Acinetobacter baumannii (n: 1), A. Iwoffii (n: 1), group viridans Streptococcus (n: 1), Mycoplasma pneumoniae (n: 1); viruses in 3 cases, metapneumovirus (n: 2) cytomegalovirus (n: 1) and fungal infection in 5 cases, Pneumocystis jiroveci (n: 2) Aspergillus fumigatus (n: 1), Aspergillus niger (n: 1), Candida albicans (n: 1). Therapeutic adjustments were done in 6/37 episodes (16.2%).
  
  
  CONCLUSIONS
  BAL has a significant role in the evaluation of pulmonary infiltrates in pediatric oncological patients, requiring a prompt and safe diagnosis, which is crucial for the survival with minimal morbidity. Our results suggest that BAL by fiberbronchoscopy should be considered as an initial diagnostic tool in these patients.
authors.affiliation: Hospital San Borja Arriarán, Santiago, Chile.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Avilés
authors.forename: Pamela
authors.initials: P
authors.lastname: Silva
authors.forename: Marcela
authors.initials: M
authors.lastname: Zubieta
authors.forename: Ana M
authors.initials: AM
authors.lastname: Alvarez
authors.forename: Ana
authors.initials: A
authors.lastname: Becker
authors.forename: Carmen
authors.initials: C
authors.lastname: Salgado
authors.forename: M Elena
authors.initials: ME
authors.lastname: Santolaya
authors.forename: Santiago
authors.initials: S
authors.lastname: Topelberg
authors.forename: Juan
authors.initials: J
authors.lastname: Tordecilla
authors.forename: Mónica
authors.initials: M
authors.lastname: Varas
authors.forename: Milena
authors.initials: M
authors.lastname: Villarroel
authors.forename: Tamara
authors.initials: T
authors.lastname: Viviani
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D001999:Bronchoscopy; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging* / Q000382:microbiology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D011446:Prospective Studies; D011859:Radiography
chemical_list: D000970:Antineoplastic Agents