Diagnostic yield of bronchial washing fluid analysis for hemoptysis in patients with bronchiectasis.
OBJECTIVE
Bronchiectasis is the main cause of hemoptysis. When patients with bronchiectasis develop hemoptysis, clinicians often perform bronchoscopy and bronchial washing to obtain samples for microbiological and cytological examinations. Bronchial washing fluids were analyzed from patients with bronchiectasis who developed hemoptysis, and the clinical impacts of these analyses were examined.


METHODS
A retrospective observational study of patients who underwent fiberoptic bronchoscopy for hemoptysis in Seoul National University Bundang Hospital, a university affiliated tertiary referral hospital, between January 2006 and December 2010 were reviewed. Among them, patients who had bronchiectasis confirmed by computed tomography and had no definite cause of hemoptysis other than bronchiectasis were reviewed. The demographic characteristics, bronchoscopy findings, microbiological data, pathology results and clinical courses of these patients were retrospectively reviewed.


RESULTS
A total of 130 patients were reviewed. Bacteria, non-tuberculous mycobacteria (NTM), and Mycobacterium tuberculosis were isolated from bronchial washing fluids of 29.5%, 21.3%, and 0.8% patients, respectively. Suspected causal bacteria were isolated only from bronchial washing fluid in 19 patients, but this analysis led to antibiotics change in only one patient. Of the 27 patients in whom NTM were isolated from bronchial washing fluid, none of these patients took anti-NTM medication during the median follow-up period of 505 days. Malignant cells were not identified in none of the patients.


CONCLUSIONS
Bronchial washing is a useful method to identify microorganisms when patients with bronchiectasis develop hemoptysis. However, these results only minimally affect clinical decisions.
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Ju-Hee
JH
Park
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Soo Jung
SJ
Kim
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Ae-Ra
AR
Lee
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Jung-Kyu
JK
Lee
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Junghyun
J
Kim
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Hyo-Jeong
HJ
Lim
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Young Jae
YJ
Cho
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Jong Sun
JS
Park
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Ho Il
HI
Yoon
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Jae-Ho
JH
Lee
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Choon-Taek
CT
Lee
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea. ; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sei Won
SW
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001987:Bronchiectasis / Q000150:complications* / Q000382:microbiology; D001999:Bronchoscopy; D005260:Female; D006469:Hemoptysis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Bronchiectasis; bronchial washing; bronchoscopy; hemoptysis