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• W2123995802 abstract "Immunocompromised children are at high risk for developing pneumonia due to opportunistic pathogens. The role of bronchoalveolar lavage (BAL) in the evaluation of such patients is still controversial. We reviewed the hospital records of immunosuppressed patients with respiratory symptoms who had undergone BAL in the pediatric department of the Hospital Clínico de la Pontificia Universidad Católica of Chile. Sixty-eight BAL were performed on 54 children (mean age: 7.5 years) receiving wide-spectrum antibiotic treatment. The most frequent respiratory signs and symptoms were fever (90%) and cough and respiratory distress (81%); 18% had neutropenia and 43% thrombocytopenia. A specific pathogen was identified in BAL samples for 25 patients (37%). The pathogens isolated were bacteria in 21 cases, viruses in 6, Pneumocystis carinii in 5, fungi in 4, and Mycobacterium tuberculosis in one. Fourteen (19%) of the children who underwent BAL were on mechanical ventilation. Outcome was satisfactory in all cases. Twenty-one complications were recorded, 17 of which were minor (mild hypoxemia or fever) and 4 major, requiring tracheal intubation. No deaths were recorded. Evaluation by fiberoptic bronchoscopy together with BAL proved to be a safe procedure with an adequate diagnostic yield that made it possible to determine the etiology of the pulmonary infiltrates seen in chest x-rays. Both positive and negative results of BAL were useful for treating the patients. LOS niños inmunodeprimidos presentan el ries-go de desarrollar neumonía por gérmenes oportunistas. El papel del lavado broncoalveolar (LBA) en la evaluación de estos pacientes es aún controvertido. Se revisaron las fichas de pacientes con inmunodepresión y síntomas respiratorios a los que se les había practicado un LBA en el Servicio de Pediatría del Hospital Clínico de la Pontificia Universidad Católica de Chile. Se practicaron 68 LBA en 54 niños inmunodeprimidos (edad media: 7,5 años). Los síntomas respiratorios más frecuentes fueron fiebre (90%) y tos y dificultad respiratoria (81%); el 18% tenía neutropenia y el 43%, trombocitopenia. Todos los pacientes estaban en tratamiento antibiótico de amplio espectro. Las muestras del LBA pro-porcionaron un germen específico en 25 pacientes (37%). Los patógenos aislados fueron: bacterias en 21 casos, virus en 6, Pneumocystis carinii en 5, hongos en 4 y Mycobacterium tuberculosis en uno. Catorce (19%) LBA se realizaron a niños que recibían ventilación mecánica. La evolución fue sa-tisfactoria en todos los casos. Se registraron 21 complicaciones, 17 menores (hipoxemia leve o fiebre) y 4 mayores que requirieron intubación traqueal. No se registraron muertes. La evaluación fibrobroncoscópica asocia-da a un LBA fue un método seguro, con un adecuado rendimiento, que permitió evaluar la etiología de los infiltrados pulmonares en la radiografía de tórax. Tanto los resultados positivos como los negativos del LBA contribuyeron al tratamiento de estos pacientes." @default.
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• W2123995802 date "2004-12-01" @default.
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• W2123995802 title "Utility of Bronchoalveolar Lavage in Immunocompromised Children: Diagnostic Yield and Complications" @default.
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• W2123995802 doi "https://doi.org/10.1016/s1579-2129(06)60377-7" @default.
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