Bronchoscopy with bronchoalveolar lavage: determinants of yield and impact on management in immunosuppressed patients
| Autor: | Jennifer A. Kelly, Wayne Ormsby, Patricia J. Sime, Michael N. Gurell, Jennifer J. Stalica, Elizabeth Lyda, R.M. Kottmann, David R. Trawick, Karoline Moon |
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| Rok vydání: | 2010 |
| Předmět: |
Pulmonary and Respiratory Medicine
Lung Diseases medicine.medical_specialty medicine.diagnostic_test biology Bronchoscopy with Bronchoalveolar Lavage business.industry Corticosteroid treatment respiratory system biology.organism_classification Stain Bronchoalveolar Lavage Surgery Immunocompromised Host Bronchoalveolar lavage Antimicrobial use Bronchoscopy Cytopathology Internal medicine medicine Humans Candida albicans business |
| Zdroj: | Thorax. 66(9) |
| ISSN: | 1468-3296 |
| Popis: | Fibreoptic bronchoscopy with bronchoalveolar lavage (FOB/BAL) is a common modality for the evaluation of pulmonary infiltrates.1 2 We recognised there are limitations of comparison between subgroups of immunosuppressed patients, non-uniform definitions of a positive yield, suboptimal description of the impact of concurrent antimicrobial use at the time of the bronchoscopy and sometimes insufficient assessment of management decisions surrounding FOB/BAL.3–5 To address these issues, we performed a retrospective analysis of 190 immunosuppressed patients who underwent FOB/BAL for a pulmonary abnormality (clinical or radiographic) at the University of Rochester Medical Center from 2005 to 2008. A positive yield was defined as one of the following: (1) positive culture—bacterial, viral or fungal (not including Candida albicans alone); (2) positive finding on cytopathology or fungal stain; or (3) diffuse alveolar haemorrhage. Antimicrobial and corticosteroid treatment changes … |
| Databáze: | OpenAIRE |
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