Experience With Flexible Fiberoptic Bronchoscopy With Bronchoalveolar Lavage as a Diagnostic Tool in Children With AIDS

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Abstract
• Objective. —To report our experience with flexible fiberoptic bronchoscopy with bronchoalveolar lavage in children with the acquired immunodeficiency syndrome and acute lower respiratory tract disease. Design. —Retrospective study. Setting. —Children's Medical Center of Brooklyn, NY, a tertiary-level inner-city hospital. Participants. —Eighty-five children with acquired immunodeficiency syndrome and acute lower respiratory tract disease. Intervention. —One hundred five flexible fiberoptic bronchoscopies with bronchoalveolar lavages. Measurements/Main Results. —Infective agents were recovered in 88 procedures (84%). Potentially pathogenic bacteria were identified in 56 (56.6%) of 99 procedures. Viruses were found in 28 (29%) of 96 lavages, and fungi in 37 (41.6%) of 89 specimens. Pneumocystis carinii was identified in 22 (22.2%) of 99 specimens. Mycobacteria were isolated from 14 (14%) of 100 specimens. A serious complication occurred in only one procedure (0.95%). Conclusion. —Flexible fiberoptic bronchoscopy with bronchoalveolar lavage is a safe and effective diagnostic procedure that identified infective agents in 80% of children with acquired immunodeficiency syndrome and concomitant acute lower respiratory tract disease. (AJDC. 1992;146:1056-1059)