EXPERIENCE WITH FLEXIBLE FIBEROPTIC BRONCHOSCOPY WITH BRONCHOALVEOLAR LAVAGE AS A DIAGNOSTIC-TOOL IN CHILDREN WITH AIDS

Objective.-To report our experience with flexible fiberoptic bronchoscopy with bronchoalveolar lavage in children with the acquired immunodeficiency syndrome and acute lower respiratory tract disease. Design.-Retrospective study. Setting-Children's Medical Center of Brooklyn, NY, a tertiary-level inner-city hospital. Participants.-Eighty-five children with acquired immunodeficiency syndrome and acute lower respiratory tract disease. Intervention.-One hundred five flexible fiberoptic bronchoscopies with bronchoalveolar lavages. Measurements/Main Results.-Infective agents were recovered in 88 procedures (84%). Potentially pathogenic bacteria were identified in 56 (56.6%) of 99 procedures. Viruses were found in 28 (29%) of 96 lavages, and fungi in 37 (41.6%) of 89 specimens. Pneumocystis carinii was identified in 22 (22.2%) of 99 specimens. Mycobacteria were isolated from 14 (14%) of 100 specimens. A serious complication occurred in only one procedure (0.95%). Conclusion.-Flexible fiberoptic bronchoscopy with bronchoalveolar lavage is a safe and effective diagnostic procedure that identified infective agents in 80% of children with acquired immunodeficiency syndrome and concomitant acute lower respiratory tract disease.