The Role of Bronchoalveolar Lavage in Diagnosing Nonopportunistic Bacterial Pneumonia (21)

In: Pulmonary function

13 May 2013

The Role of Bronchoalveolar Lavage in Diagnosing Nonopportunistic Bacterial Pneumonia (21)Older studies have suggested that the antibacterial activity of lidocaine reduces the yield for recovering mycobacteria, a factor, however, not supported by more recent work. Concomitant therapy, instead, may affect result of cultures. When bronchoscopy is performed, BAL has been shown to be the procedure with the highest diagnostic yield. De Gracia et al reported on 17 patients with tuberculosis who had negative serial sputum and gastric aspirate for acid-fast bacilli, BAL cultures for M tuberculosis were positive in 15 (88 percent) and the direct smear in 3 (17 percent). buy yasmin online

The sensitivity of bronchial washing and postbronchoscopy sputum in this group was 53 percent and 46 percent, respectively. Baughman et al subjected to FOB with BAL 30 patients with pulmonary tuberculosis who had smear-negative sputum samples. The bronchoscopy specimen (BAL or washing) was smear positive in 15 (50 percent) and culture positive in 26 (87 percent). Only nine (30 percent) of the patients had a prebronchoscopy sputum specimen that was subsequently culture positive. Bronchoscopy specimens were superior to sputum culture alone for diagnosing M tuberculosis (p<0.001). For patients with miliary pattern on chest roentgenogram, sputum cultures had a low yield (25 percent), while cultures of secretions obtained by bronchoscopy were positive in 100 percent.


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