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. 1977 Oct;32(5):539–545. doi: 10.1136/thx.32.5.539

Diagnostic fibreoptic bronchoscopy in the immunocompromised host with pulmonary infiltrates.

R A Matthay, W C Farmer, D Odero
PMCID: PMC470785  PMID: 594932

Abstract

Nineteen immunocompromised patients with pulmonary infiltrates underwent diagnostic fibreoptic bronchoscopy with transbronchial forceps and brush biopsy. A specific diagnosis was obtained in 21/25 procedures (10/11 focal lesions and 11/14 diffuse legions). The most common diagnosis was infection, and organisms isolated included bacteria, fungi, Pneumocystis carinii, and herpes simplex. A pneumothroax requiring tube drainage occurred in two cases and mild lung parenchymal bleeding was noted in two others. It is concluded that fibreoptic bronchoscopy with forceps and brush biopsy can be performed safely with an excellent diagnostic yield in immunocompromised hosts with lung lesions. Supplemental oxygen should be administered during fibreoptic procedures in these patients and platelet transfusions should be given when thrombocytopenia is present.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albertini R. E., Harrell J. H., Moser K. M. Management of arterial hypoxemia induced by fiberoptic bronchoscopy. Chest. 1975 Feb;67(2):134–136. doi: 10.1378/chest.67.2.134. [DOI] [PubMed] [Google Scholar]
  2. Amikam B., Landa J., West J., Sackner M. A. Bronchofiberscopic observations of the tracheobronchial tree during intubation. Am Rev Respir Dis. 1972 May;105(5):747–755. doi: 10.1164/arrd.1972.105.5.747. [DOI] [PubMed] [Google Scholar]
  3. Andersen H. A., Fontana R. S. Transbronchoscopic lung biopsy for diffuse pulmonary diseases: technique and results in 450 cases. Chest. 1972 Aug;62(2):125–128. doi: 10.1378/chest.62.2.125. [DOI] [PubMed] [Google Scholar]
  4. Cunningham J. H., Zavala D. C., Corry R. J., Keim L. W. Trephine air drill, bronchial brush, and fiberoptic transbronchial lung biopsies in immunosuppressed patients. Am Rev Respir Dis. 1977 Feb;115(2):213–220. doi: 10.1164/arrd.1977.115.2.213. [DOI] [PubMed] [Google Scholar]
  5. Ellis J. H., Jr Transbronchial lung biopsy via the fiberoptic bronchoscope. Experience with 107 consecutive cases and comparison with bronchial brushing. Chest. 1975 Oct;68(4):524–532. doi: 10.1378/chest.68.4.524. [DOI] [PubMed] [Google Scholar]
  6. Ellis R. Traumatic lung cysts. JAMA. 1976 Oct 25;236(17):1976–1977. [PubMed] [Google Scholar]
  7. Finley R., Kieff E., Thomsen S., Fennessy J., Beem M., Lerner S., Morello J. Bronchial brushing in the diagnosis of pulmonary disease in patients at risk for opportunistic infection. Am Rev Respir Dis. 1974 Mar;109(3):379–387. doi: 10.1164/arrd.1974.109.3.379. [DOI] [PubMed] [Google Scholar]
  8. Fry W. A., Manalo-Estrella P. Bronchial brushing. Surg Gynecol Obstet. 1970 Jan;130(1):67–71. [PubMed] [Google Scholar]
  9. Greenman R. L., Goodall P. T., King D. Lung biopsy in immunocompromised hosts. Am J Med. 1975 Oct;59(4):488–496. doi: 10.1016/0002-9343(75)90256-9. [DOI] [PubMed] [Google Scholar]
  10. Hanson R. R., Zavala D. C., Rhodes M. L., Keim L. W., Smith J. D. Transbronchial biopsy via flexible fiberoptic bronchoscope; results in 164 patients. Am Rev Respir Dis. 1976 Jul;114(1):67–72. doi: 10.1164/arrd.1976.114.1.67. [DOI] [PubMed] [Google Scholar]
  11. Kahn M. A., Whitcomb M. E., Snider G. L. Flexible fiberoptic bronchoscopy. Am J Med. 1976 Aug;61(2):151–155. doi: 10.1016/0002-9343(76)90162-5. [DOI] [PubMed] [Google Scholar]
  12. Kazatchkine M., Sultan Y., Caen J. P., Bariety J. Bleeding in renal failure: a possible cause. Br Med J. 1976 Sep 11;2(6036):612–615. doi: 10.1136/bmj.2.6036.612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Levin D. C., Wicks A. B., Ellis J. H., Jr Transbronchial lung biopsy via the fiberoptic bronchoscope. Am Rev Respir Dis. 1974 Jul;110(1):4–12. doi: 10.1164/arrd.1974.110.1.4. [DOI] [PubMed] [Google Scholar]
  14. Repsher L. H., Schröter G., Hammond W. S. Diagnosis of Pneumocystis carinii pneumonitis by means of endobronchial brush biopsy. N Engl J Med. 1972 Aug 17;287(7):340–341. doi: 10.1056/NEJM197208172870708. [DOI] [PubMed] [Google Scholar]
  15. Ries K., Levison M. E., Kaye D. Transtracheal aspiration in pulmonary infection. Arch Intern Med. 1974 Mar;133(3):453–458. [PubMed] [Google Scholar]
  16. Smiddy J. F., Ruth W. E., Kerby G. R., Renz L. E., Raucher C. Flexible fiberoptic bronchoscope. Ann Intern Med. 1971 Dec;75(6):971–972. doi: 10.7326/0003-4819-75-6-971. [DOI] [PubMed] [Google Scholar]
  17. Zavala D. C. Diagnostic fiberoptic bronchoscopy: Techniques and results of biopsy in 600 patients. Chest. 1975 Jul;68(1):12–19. doi: 10.1378/chest.68.1.12. [DOI] [PubMed] [Google Scholar]

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