Henríquez A, Srur E, Giglio M, Fernández A, Cona E, Lorca M, García A, Northland R, Segovia J, Gutiérrez S
Servicio de Medicina, Hospital San Juan de Dios, Santiago de Chile.
Rev Med Chil. 1993 Mar;121(3):279-85.
to assess the usefulness of fiberoptic bronchoscopy in the etiologic diagnosis of pulmonary infiltrates in patients with AIDS.
in 25 patients with AIDS and pneumonia, 31 fiberoptic bronchoscopies with bronchoalveolar lavage were performed; in 11 occasions, a transbronchial biopsy was also performed.
in 24 of the 31 procedures (77%) an etiologic diagnosis was made. There were 7 false negative results; in two of these patients, a repeated examination allowed an etiologic diagnosis. The etiologies of the infiltrates were pyogenic bacteria in 14 cases. Pneumocystis carinii in 9, mycobacteria in 3, cytomegalovirus in one and a lymphocytic interstitial pneumonia in one. In 5 patients, the association of two or more etiological agents was observed. Except one case, all patients had a good response to specific treatments. There were no complications attributed to the bronchoscopic procedure.
fiberoptic bronchoscopy and bronchoalveolar lavage are safe and effective procedures for the etiologic diagnosis of pulmonary infiltrates in patients with AIDS.
评估纤维支气管镜检查在艾滋病患者肺部浸润病因诊断中的作用。
对25例患艾滋病且患有肺炎的患者进行了31次纤维支气管镜检查及支气管肺泡灌洗；11次检查时还进行了经支气管活检。
31次检查中有24次（77%）做出了病因诊断。有7次结果为假阴性；其中2例患者经再次检查后做出了病因诊断。浸润的病因有14例为化脓性细菌，9例为卡氏肺孢子虫，3例为分枝杆菌，1例为巨细胞病毒，1例为淋巴细胞间质性肺炎。5例患者观察到两种或更多病原体并存。除1例患者外，所有患者对特异性治疗反应良好。未出现与支气管镜检查相关的并发症。
纤维支气管镜检查及支气管肺泡灌洗是艾滋病患者肺部浸润病因诊断的安全有效方法。
