Abstract
In a prospective study the efficacy of fiberoptic bronchoscopy was evaluated in the diagnosis of infections with opportunistic pathogens, Kaposi's sarcoma and nonspecific interstitial pneumonitis in 171 episodes of pneumonitis in 151 HIV-infected patients. Samples were collected by suction through the inner aspiration channel of the bronchoscope (n=164), telescoping plugged catheter (n=117) and transbronchial lung biopsy (n=82). A high incidence of infections with pyogenic bacteria (12 %),Legionella spp. (5 %) andMycobacterium tuberculosis were diagnosed (9 %). Bronchoalveolar lavage demonstrated a high diagnostic rate in bacterial pneumonia (significance level > 105 cfu/ml) and a low degree (10 %) of contamination (< 1 % squamous epithelial cells). Bronchoalveolar lavage was more effective than the telescoping plugged catheter in yielding a significant number of colonies in patients with bacterial pneumonia previously treated with antibiotics. Nondiagnosed pneumonitis was more frequent in intravenous drug abusers than in homosexual men (p<0.001).
Similar content being viewed by others
References
Suffredini AF, Masur H: Pulmonary dysfunction in patients infected with HIV. In: Pennington JE (ed): Respiratory infections: diagnosis and management. Raven Press, New York, 1988, p. 241–263.
Murray JF, Garay SM, Hopewell PC, Mills J, Snider GL, Stover DE: Pulmonary complications of the acquired immunodeficiency syndrome. An update. Report of the Second National Heart, Lung and Blood Institute Workshop. American Review of Respiratory Diseases 1987, 135: 504–509.
Stover DE, White DA, Romano PA, Gellene RA, Robeson WA: Spectrum of pulmonary diseases associated with the AIDS. American Journal of Medicine 1985, 78: 429–437.
Murray JF, Felton CP, Garay SM, Gottieb MS, Hopewell PC, Stover DE, Tierstein AS: Pulmonary complications of the AIDS: Report of a National, Lung and Blood Institute Workshop. New England Journal of Medicine 1984, 310: 1682–1688.
Witt DJ, Craven DE, McCabe WR: Bacterial infections in adult patients with the AIDS and AIDS-related complex. American Journal of Medicine 1987, 82: 900–906.
Wimberley NW, Faling J, Bartlett JG: A fiberoptic bronchoscopy technique to obtain uncontaminated lower airway secretions for bacterial culture. American Review of Respiratory Diseases 1979, 119: 337–343.
Reynolds HY: Bronchoalveolar lavage. American Review of Respiratory Diseases 1987, 135: 250–263.
Khan FW, Jones JM: Diagnosing bacterial respiratory infection by bronchoalveolar lavage. Journal of Infectious Diseases 1987, 155: 862–869.
Suffredini AF, Ognibene FP, Lack EE: Nonspecific interstitial pneumonitis: a common cause of pulmonary disease in acquired immunodeficiency syndrome. Annals of Internal Medicine 1987, 107: 7–13.
Barlett JG, Alexander J, Mayhew J, Sullivan-Sigler N, Gorbach SL: Should fiberoptic bronchoscopy aspirates be cultured? American Review of Respiratory Diseases 1976, 114: 73–78.
Pollock HM, Hawkins EL, Bonner JR, Sparkmam T, Bass JB: Diagnosis of bacterial pulmonary infections during quantitative protected catheter cultures obtained during bronchoscopy. Journal of Clinical Microbiology 1983, 17: 255–259.
Wimberley NW, Bass JB, Boyd BW: Use of bronchoscopic protected catheter brush for the diagnosis of pulmonary infections. Chest 1982, 81: 556–562.
Chastre J, Fagon JY, Domart Y, Gibert C: Diagnosis of nosocomial pneumonia in intensive care unit patients. European Journal of Clinical Microbiology & Infectious Diseases 1989, 8: 35–39.
Barlett JG: Invasive diagnostic techniques in pulmonary infections. In: Pennington JE (ed): Respiratory infections: diagnosis and management. Raven Press, New York, 1988, p. 69–96.
Kahn FW, Jones JM: Analysis of bronchoalveolar lavage specimens from immunocompromised patients with a protocol applicable in the microbiology laboratory. Journal of Clinical Microbiology 1988, 26: 1150–1155.
Higuchi JH, Coalson JJ, Johanson WG: Bacteriologic diagnosis of nosocomial pneumonia in primates. American Review of Respiratory Diseases 1982, 125: 53–57.
Thorpe JE, Baughman RP, Frame PT, Wesseler TA, Staneck JL: Bronchoalveolar lavage for diagnosing acute bacterial pneumonia. Journal of Infectious Diseases 1987, 155: 855–861.
Holtz HA, Lavery DP, Kapila R: Actinomycetales infection in the acquired immunodeficiency syndrome. Annals of Internal Medicine 1985, 102: 203–205.
Polsky B, Gold JWM, Whimbey E, Dryjanski J, Brown AE, Schiffman G, Armstrong D: Bacterial pneumonia in patients with the acquired immunodeficiency syndrome. Annals of Internal Medicine 1986, 104: 38–41.
Jacobson MA, Mills J: Pulmonary effects of AIDS: cytomegalovirus infection. Clinics in Chest Medicine 1988, 9: 443–448.
Ognibene FP, Masur H, Rogers P, Travis WD, Suffredini AF, Feuerstein I, Gill V, Baird BF, Carasquillo JA, Parrillo JE, Lane HC, Shelhamer JH: Nonspecific interstitial pneumonitis without evidence ofPneumocystis carinii in asymptomatic patients infected with human immunodeficiency virus. Annals of Internal Medicine 1988, 109: 874–879.
Williams MH: Pulmonary complications of drug abuse. In: Fishman AP (ed): Pulmonary diseases and disorder. McGraw-Hill, New York 1988, p. 793–812.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jiménez, M.L., Aspa, J., Padilla, B. et al. Fiberoptic bronchoscopic diagnosis of pulmonary disease in 151 HIV-infected patients with pneumonitis. Eur. J. Clin. Microbiol. Infect. Dis. 10, 491–496 (1991). https://doi.org/10.1007/BF01963935
Issue Date:
DOI: https://doi.org/10.1007/BF01963935