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[与人类免疫缺陷病毒相关的感染:纤维支气管镜检查的指征及重要性]

[HIV-associated infections: indications and importance of fiberoptic bronchoscopy].

作者信息

Fischer B, Elmer M, Ramadori G, Lorenz J

机构信息

III. Medizinische Klinik, Abetilung Innere Medizin-Pneumologie, Universitätskliniken Mainz.

出版信息

Pneumologie. 1990 Feb;44 Suppl 1:316-7.

PMID:2367404
Abstract

In 32 patients infected with HIV with unclear fever and/or pulmonary infiltraes, a fiberbronchoscopy (FB), with transbronchial lung biopsies (TBB) and bronchoalveolar lavage (BAL) was carried out. Thirteen of these patients had pneumocystis carinii pneumonia (PCP), three patients tuberculosis of the lungs, two patients pneumococcal pneumonia, and one patient each had a staphylococcal pneumonia, an enterobacter cloacae pneumonia, and an unspecific alveolitis. Thus, 66% of the patients proved diagnostically diagnosable by FB, so that appropriate therapy could be instituted. It proved possible to diagnose 77% of the PCP cases by TBB, and 62% by BAL. Thus, the combined use of both procedures increases the sensitivity of FB in detecting PCP. In two patients with PCP, no pulmonary infiltrations were to be seen. In no case was FB associated with any complications that required treatment. Through the additional use of other diagnostic procedures for identifying the organism, it proved possible to establish a total of 46 individual diagnoses. These results underscore the frequency of multiple infections in this group of patients.

摘要

对32例不明原因发热和/或肺部浸润的HIV感染患者进行了纤维支气管镜检查(FB),同时进行了经支气管肺活检(TBB)和支气管肺泡灌洗(BAL)。其中13例患者患有卡氏肺孢子虫肺炎(PCP),3例患有肺结核,2例患有肺炎球菌肺炎,1例分别患有葡萄球菌肺炎、阴沟肠杆菌肺炎和非特异性肺泡炎。因此,66%的患者通过FB可明确诊断,从而能够开始适当的治疗。经TBB诊断出77%的PCP病例,经BAL诊断出62%的PCP病例。因此,两种方法联合使用可提高FB检测PCP的敏感性。2例PCP患者未见肺部浸润。FB在任何情况下均未引发需要治疗的并发症。通过额外使用其他诊断方法来识别病原体,共确诊了46例个体病例。这些结果强调了该组患者多重感染的频率。

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