Chest
Clinical InvestigationsDiagnostic Fiberoptic Bronchoscopy in Patients with Community-acquired Pneumonia: Comparison Between Bronchoalveolar Lavage and Telescoping Plugged Catheter Cultures
Section snippets
Patients
Forty patients (31 male), with a mean age of 42.5 ± 20.3 years, were studied. Seventeen were alcoholics, 14 were heavy smokers, and 8 patients had COPD. Other underlying diseases included three cases of diabetes mellitus, and one each of the following: chronic renal failure, asthma, breast cancer, rheumatoid arthritis, hepatic cirrhosis, and obstructive jaundice. The mean arterial oxygen partial pressure was 68.5 ± 18.2 mm Hg with a mean P(A-a)O2 of 41.4 ± 17.2 mm Hg. The white blood cell count
RESULTS
In 28 (70 percent) of 40 cases of CAP studied, a definite etiology was confirmed by microbiologic methods. Results are shown in Table 1. Altogether, 31 microorganisms were cultured in significant counts; S pneumoniae (75 percent) and Haemophilus influenzae (21 percent) were the most frequent agents found (both agents in two cases).
DISCUSSION
The results of this study demonstrate that quantitative BAL cultures are as reliable as TPC cultures in diagnosing etiology of CAP.
Few studies have examined the diagnostic value of bronchoscopic techniques in patients with CAP. Sörensen et al8 studied 36 patients with severe CAP and performed a very thorough diagnostic study that included bronchoscopy with TPC. Although bronchoscopic tests were performed in patients receiving antibiotics, the authors were able to establish an etiologic
ACKNOWLEDGMENT:
We are indebted to Dr. A. P. Cristoffanini for his invaluable help and criticism in reviewing the manuscript.
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Supported by a grant from Comisión Nacional de Investigación Científica y Tecnológica (Proyecto FONDECYT 043/89).