Clinical outcomes and complications of fiberoptic bronchoscopy in HIV-infected patients (original) (raw)
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A new bronchoscopic technique for the diagnosis of bacterial pneumonia in HIV-positive patients
Respiratory Medicine, 1997
The aim of the present study was to evaluate in HIV-positive patients with bacterial pneumonia, the diagnostic value of a new endoscopic technique that uses a single catheter to perform a telescopic plugged catheter (TPC) followed by a modified protected bronchoalveolar lavage (mpBAL). Fifty-eight HIV-positive patients with respiratory infection were included in the study. Samples from TPC and mpBAL were cultured quantitatively.
Diagnostic flexible bronchoscopy in human immunodeficiency virus (HIV)-positive children
International journal of pediatric otorhinolaryngology, 1989
Twelve children with laboratory evidence of human immunodeficiency virus (HIV) infection underwent diagnostic flexible bronchoscopy with washings or bronchoalveolar lavage at Bellevue Hospital Center from October 1987 to April 1989. The patients included 7 boys and 5 girls ranging from age 3.5 months to 10 years 5 months. Indications for bronchoscopy included respiratory distress with or without focal changes on chest radiograph in 11 patients, and persistent but asymptomatic right middle lobe collapse in one child. The etiology of pneumonia was diagnosed in 7 children and included Pneumocystis carinii, (PCP) (17%), Streptococcus viridans (17%), mechanical obstruction (17%) and cytomegalovirus (CMV) (8%). Bronchoscopy was non-diagnostic in 5 cases. Techniques for maximal yield of information using flexible bronchoscopy in HIV-positive children are discussed.
European Journal of Clinical Microbiology & Infectious Diseases, 1991
h e a 2, A. Gonzfilez 2, J. F r a g a 3, I. Santos 4, R. M a r t f n e z 5, R G d m e z H e r r u z 1, M. L 6 p e z -B r e a I In a prospective study the efficacy of fibcroptic 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 HlV-infected patients. Samples were collected by suction through Ithe inner aspiration channel of the bronchoscope (n = 164), telescoping plugged catheter (n = 117) and transbronchial lung biopsy (u = 82). A high incidence of infections with pyogenic bacteria (12 %), Legionella spp. (5 %) and Mycobacterium tuberculosis were diagnosed (9 %).
Acta medica Indonesiana, 2017
diagnostic of pulmonary TB in HIV patients is a problem due to non specific clinical features, or radiological appearance. HIV patients with CD4≤200 cells/mL infected with M. tuberculosis have less capacity in containing M. tuberculosis, developing granulomas, casseous necrosis, or cavities. This condition is caused by weakend inflammatory which later reduced sputum production and may cause false negative result. This study aimed to assess differences in the positivity level of acid fast bacilli (AFB) and cultures of M. tuberculosis from non-bronchoscopic sputum (spontaneous and induced sputum) compared to bronchoscopic sputum (bronchoalveolar lavage) in HIV positive patients suspected pulmonary tuberculosis with CD4<200 cells/μL. this cross sectional study was conducted in adult HIV patients treated in Hasan Sadikin Hospital with CD4≤200 cells/μL suspected with pulmonary tuberculosis by using paired comparative analytic test. All patients expelled sputum spontaneously or with sp...
Role of bronchoscopy in diagnosis of pulmonary infections in non-HIV immune compromised host
2018
Background: The occurrence of pulmonary infections is a common life threatening complication in immunocompromised patients, necessitating timely diagnosis and specific treatment. In our study bronchoscopic diagnostic techniques that include fiber optic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) were applied in non-HIV immunocompromised conditions to determine the aetiology infectious microorganisms and comparing the clinical characteristics with bronchoscopic yield and to assess the influence of these methods on therapeutic outcome in this population. Methods: This prospective observational study was conducted at Rajiv Gandhi Government General Hospital, Park Town, Chennai, for a period of 8 months from January 2016 – August 2016.After meeting the requirements of eligibility criteria, the study included 65 immunocompromised patients consecutively who presented with pulmonary diseases. The primary outcome measure was the diagnostic yield of bronchoscopy among non-HIV immunoc...
European Journal of Radiology, 2004
Nearly all patients infected with HIV experience respiratory infection at some point in the course of their illness. The spectrum of infections is varied and in order to generate a useful differential diagnosis based on imaging findings it is imperative for the radiologist to be aware of changing trends in disease prevalence and epidemiology, and the possible pathology related to new therapies. The characterization of the radiographic pattern in correlation with clinical findings and laboratory values (in particular the degree of immunosuppression as reflected in the CD4 level) would be helpful in narrowing the differential diagnosis of infectious pulmonary disease in HIV-positive patients. The most common radiologic patterns considered include areas of ground-glass, consolidation, nodules, and lymphadenopathy. We also include airways diseases and cavitary/cystic lesions because their prevalence has increased over recent years, and we also mention the significance of a normal chest radiograph in the suspicion of a lung infection. In most cases, the clinical and radiographic findings are sufficient for confident diagnosis. The radiologic diagnosis of thoracic infections in patients with AIDS has improved with the use of CT. The greatest value of CT is in excluding lung disease when the radiographic findings are equivocal and in confirming the presence of clinically suspected disease when the radiograph is normal.
Radiographic Aspects Of Lung Disease During Hiv Infection, Pediatrics At Cnhu / Hkm Cotonou
International Journal Of Medical Science And Clinical Invention, 2016
Objective: To study the radiographic aspects of lung infections in children with HIV in pediatrics at CNHU Cotonou. Patients and methods: The study took place in the medical imaging department and the pediatric ward of CNHU / HKM Cotonou. He acted in a cross-sectional descriptive study retrospective collection which ran from 1 January 2003 to 31 December 2012. The data collection was to take the information from patient records; and proofreading radiographs by two radiologists. Results: The study population consists of 56 children, of which 55.4% boys and 44.6% girls. Children age between 1 year and 6 years old accounted for 46.4%. Only 26.8% of children showed no immune deficiency. Radiographically, the lesions were bilateral in 57.2% of cases. Bronchial syndrome accounted for 42.7% of cases followed by alveolar syndrome with 31.7% of cases. The lesions were scattered in subjects with moderate and severe immune deficiency. It was the same in cases of pneumocystis pneumonia and tuberculosis. We observed a discrepancy between the diagnostic hypotheses and diagnostics retained after completion of the chest radiograph (P = 0.000). Bronchitis and pneumonia were the most common radiographic diagnostic hypotheses with 45% and 33% respectively .The banal germs pneumonia (37.5%), bronchitis (30.3%), Pneumocystis carinii pneumonia (16.1%) and tuberculosis (14.3%). Conclusion: In the majority of cases, chest X-ray to reframe the final diagnosis. In front of pneumonia in children infected with HIV, we should strive to eliminate in the first place, diagnostics such as bacterial pneumonia, Pneumocystis carinii pneumonia and tuberculosis.
Brazilian Journal of Infectious Diseases, 2007
Induced sputum is a useful technique for assessing airway inflammation, but its role in the diagnosis of lung disease in immunosuppressed patients needs further investigation. This study compared the use of induced sputum and BAL in the diagnosis of pneumocystosis, in HIV patients. From January 1, 2001, to December 30, 2002, HIV-positive patients older than 14 were evaluated at a hospital in Florianópolis, Santa Catarina, Brazil. Patients with respiratory symptoms for seven days or longer, with a normal or abnormal chest X-ray, and those without respiratory symptoms but with an abnormal chest X-ray, were included in the study. All patients were submitted to clinical, radiological and laboratory evaluation, after which induced sputum and bronchoscopy with bronchoalveolar lavage were carried out. The samples were subjected to the following techniques: Gram and Ziehl-Neelsen staining, quantitative culture growth for pyogenic bacteria, direct staining for fungi, culture growth for mycobacteria and fungi, and Grocott-Gomori staining for Pneumocystis jiroveci, as well as total and differential cell counts. The samples with P. jiroveci were selected, as well as the samples for which no etiologic agents were observed. Forty-five patients with a mean age of 34.6, 38 male and 40 Caucasian, comprised the subjects. Interstitial infiltrate was the most frequent radiological pattern (53.3%). The induced sputum sensitivity was 58.8%, specificity 81.8%, predictive positive value 90.9%, predictive negative value 39.1% and accuracy 64.4%, for the diagnosis of pneumocystosis, compared with BAL. Based on these data, induced sputum is a useful technique for the diagnosis of pneumocystosis in HIV patients.