Santos JPVD, Leite LFG, Adad SJ, Vergara MLS, Micheletti AMR. Main findings and diagnostic yield of bronchoalveolar lavage, bronchial brushing and transbronchial biopsy in HIV-positive patients.
Rev Inst Med Trop Sao Paulo 2019;
61:e61. [PMID:
31778391 PMCID:
PMC6880975 DOI:
10.1590/s1678-9946201961061]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 10/30/2019] [Indexed: 11/22/2022] Open
Abstract
Bronchoalveolar lavage, bronchial brushing and transbronchial biopsy are of
fundamental importance in the diagnosis of pathologies affecting the lungs of
immunosuppressed patients, especially those infected with HIV. This was a
descriptive and retrospective study, in which the results of bronchoalveolar
lavages, bronchial brushings and transbronchial biopsies of HIV-positive
patients attended at the Clinical Hospital of the Federal University of
Triangulo Mineiro from 1999 to 2015 were reviewed to determine the most frequent
findings in these patients, to evaluate the diagnostic accuracy of these
procedures and to correlate bronchoscopy results with clinical and radiological
findings. Serological tests for HIV were confirmed and cases with negative or
unverified serology were excluded. Medical records were reviewed for correlation
with clinical and radiological findings. A total of 1,423 patients with a mean
age of 50 years were initially selected; 727 cases had no serology for HIV; 696
had serology for HIV and 64 were positive. Of these, 47 were men, aged 24 to 84
years, and 17 women, aged 31 to 69 years. Biopsies and cytological tests were
positive in 20 (31.25%) of the 64 patients and the most frequent diagnosis was
pneumocystosis, found in 8 cases (12.5%). Of the 20 bronchofibroscopy-positive
patients, only 2 did not show agreement between histopathological and
clinical-radiological diagnoses. The analysis of the cytological tests and
biopsy specimens obtained by bronchofibroscopy seems to be valuable for the
etiological diagnosis of pulmonary infections in HIV- positive patients;
however, negative results do not always exclude the diagnosis. In these cases,
clinical symptoms and imaging findings may help to guide the best therapy.
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