Document Detail


Value of repeat fiberoptic bronchoscopies and significance of nondiagnostic bronchoscopic results in patients with the acquired immunodeficiency syndrome.
MedLine Citation:
PMID:  3813206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Out of 286 patients with the acquired immunodeficiency syndrome (AIDS) who had fiberoptic bronchoscopies performed for the diagnosis of pulmonary disease, 21 (7.3%) patients (Group I) had repeat procedures after 1 to 30 days (mean, 14.8 days) because of persistent pulmonary infiltrates despite therapy, and 46 (15.9%) patients (Group II) had repeat procedures after 2 to 32 months (mean, 7.5 months) because of recurrent pulmonary infiltrates after initial clinical and radiographic improvement. Pneumocystis carinii pneumonia was the most common diagnosis in both groups on initial evaluation, being found in 55% of the patients. Repeat bronchoscopy yielded a new treatable diagnosis in 1 (5%) of 21 patients in Group I and in 27 (59%) of 46 patients in group II. Sixty-two percent of patients in Group I died within 1 month. It appears that in patients with AIDS who have persistent or worsening pulmonary infiltrates despite therapy, repeat bronchoscopy after a short interval (i.e., less than 1 month) is unlikely to have therapeutic implications. In contrast, those patients whose pulmonary involvement resolves initially may benefit from an aggressive diagnostic approach if new pulmonary infiltrates appear. In both groups, nondiagnostic bronchoscopies were common (29% overall). The most commonly missed bronchoscopic diagnoses (proved by open lung biopsy) were cytomegalovirus pneumonia and Kaposi's sarcoma, and neither had much therapeutic implication. Further, 12 patients in Group II with nondiagnostic bronchoscopies improved both radiographically and clinically even though no treatment was given.
Authors:
J L Barrio; C Harcup; H J Baier; A E Pitchenik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  135     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-03-11     Completed Date:  1987-03-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  422-5     Citation Subset:  AIM; IM; X    
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications,  pathology*
Adult
Bronchi / pathology*
Bronchoscopy / standards*
Evaluation Studies as Topic
Female
Fiber Optic Technology
Humans
Lung Diseases / complications,  diagnosis
Male
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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