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Titolo:
Diagnostic yield of bronchoscopy in histologically proven invasive pulmonary aspergillosis
Autore:
Reichenberger, F; Habicht, J; Matt, P; Frei, R; Soler, M; Bolliger, CT; Dalquen, P; Gratwohl, A; Tamm, M;
Indirizzi:
Univ Basel Hosp, Div Pneumol, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 ol, CH-4031 Basel, Switzerland Univ Basel Hosp, Div Haematol, CH-4031 Basel, Switzerland Univ Basel HospBasel Switzerland CH-4031 ol, CH-4031 Basel, Switzerland Univ Basel Hosp, Dept Internal Med, Bacteriol Lab, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 ab, CH-4031 Basel, Switzerland Univ Basel Hosp, Div Thorac Surg, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 rg, CH-4031 Basel, Switzerland Univ Basel Hosp, Inst Pathol, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 ol, CH-4031 Basel, Switzerland
Titolo Testata:
BONE MARROW TRANSPLANTATION
fascicolo: 11, volume: 24, anno: 1999,
pagine: 1195 - 1199
SICI:
0268-3369(199912)24:11<1195:DYOBIH>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; BRONCHOALVEOLAR LAVAGE FLUID; ANTIGEN-DETECTION; NEUTROPENIC PATIENTS; ACUTE-LEUKEMIA; SURGICAL-MANAGEMENT; EPIDEMIOLOGY; INFECTIONS; CULTURES; PCR;
Keywords:
invasive pulmonary aspergillosis; bronchoscopy; bronchoalveolar lavage;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Tamm, M Univ Sydney, Inst Resp Med, POB M77, Camperdown, NSW 2050, Australia Univ Sydney POB M77 Camperdown NSW Australia 2050 2050, Australia
Citazione:
F. Reichenberger et al., "Diagnostic yield of bronchoscopy in histologically proven invasive pulmonary aspergillosis", BONE MAR TR, 24(11), 1999, pp. 1195-1199

Abstract

Invasive pulmonary aspergillosis (IPA) is a life-threatening infectious complication in neutropenic patients after high-dose chemotherapy or hematopoietic stem cell transplantation. Its diagnosis is mainly based on clinical symptoms, and radiological signs on thoracic CT scan. The value of bronchoscopy is controversial. We analyzed the diagnostic yield of bronchoscopy in 23 consecutive patients with histologically proven invasive pulmonary aspergillosis, In seven patients (30%) bronchoscopically obtained specimens werediagnostic for pulmonary fungal infection. Typical hyphae were detected bycytology in six patients and fungal cultures were positive in four cases. Patients with a positive bronchoscopic result presented more often with multiple changes on thoracic CT scan (71%; 5/7), but had received a lower median cumulative dose of amphotericine B (300 mg; 168-3010 mg) compared to patients with non-diagnostic bronchoscopy (25% multiple lesions (4/16); amphotericine dose 1100 mg, 260-2860 mg), The diagnostic yield of bronchoscopy was not associated with clinical symptoms or duration of neutropenia, Bronchoscopy allows the diagnosis of IPA in about one third of patients. Fungal cultures and cytological examination of intrabronchial specimens obtained during bronchoscopy have a high specificity, but its sensitivity is low. It isadvisable to perform diagnostic bronchoscopy before starting antifungal therapy. Better diagnostic tools are urgently needed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 17:56:53