Broncho-alveolar lavage: An aid to diagnosis in immuncompromised children with pulmonary lesion.

ABSTRACT

Conventional broncho-alveolar lavage with flexible bronchoscope has proven to be an effective method for the diagnosis of pulmonary lesions, especially in immunocompromised patients. The disadvantage of flexible endoscopy is that it can not be performed safely in pediatric patients with compromised airway due to the lack of ventilating channel. We designed an alternative method for broncho-alveolar lavage by target bronchus and secure the airway at the same time. We performed brocho-alveolar lavage via that method in 15 immunocompromised paediatric patients with signs and symptoms of pneumonia from December 1995 to September 1997. The group comprised eight males and seven females with a mean age of 30.35+24.60 months. Most of the patients had positive HIV titre (86.67 percent). Causative agents were identified in 11 of 15 patients (77.33 percent) Pneumocystis carinii was found in four cases (26.7 percent) followed by fungus (four cases, 26.7 percent), Mycobacterium tuber culosis (one cases, 6.7 percent) and Respiratory syncytial virus (one cases, 6.7 percent). No complications were reported. Compared to the literature control which gave an average yield of 45-84 percent, this technique of brocho-alveolar lavage was proven to be an effective, safe diagnostic method which gave satisfactory results.