Diagnostic Yield of Bronchoalveolar Lavage in Immunocompromised Children

Author:

Wong Jeff Chin Pang1,Hon Kam Lun Ellis1ORCID,Leung Karen Ka Yan1ORCID,Qian Suyun2,Leung Alexander K C34

Affiliation:

1. Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Hong Kong

2. Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China

3. Department of Pediatrics, The University of Calgary, The Alberta Children's Hospital, Calgary, AB, Canada

4. Department of Pediatrics, The Alberta Children’s Hospital, Calgary, AB, Canada

Abstract

Abstract Results from early studies in the diagnostic yield of bronchoalveolar lavage (BAL) in immunocompromised adults and children were variable. This prospective study aimed to determine the diagnostic yield of BALs in immunocompromised children over the first 18 months of service at a newly established children’s hospital. Relationship between BAL results and changes in antimicrobial management was also studied. Twenty-one bronchoscopic BALs were performed on 18 children; 14 BALs (66.7%) yielded at least 1 pathogen and 7 (33.3%) yielded no pathogen. Two pathogens were found in 2 samples, and 1 pathogen was identified in 12 samples. Bacteria (n = 7 patients), viruses (n = 8 patients) and fungus (Pneumocycstis jirovecii in one patient) were yielded. Of the 21 BALs, 8 (38.1%) were associated with changes in antimicrobial management (Fisher’s exact test, p = 0.018). No significant side effects such as pneumothorax or pulmonary hemorrhages were observed in this series. In conclusion, BAL in immunocompromised children is rewarding and has potential to impact on antimicrobial management.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pediatrics, Perinatology, and Child Health

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