Bronchoscopic diagnosis of pneumonia

Vickie S. Baselski*, Richard G. Wunderink

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

132 Scopus citations

Abstract

Lower respiratory tract infections are characterized by significant morbidity and mortality but also by a relative inability to establish a specific etiologic agent on clinical grounds alone. With the recognized shortcomings of expectorated or aspirated secretions toward establishing an etiologic diagnosis, clinicians have increasingly used bronchoscopy to obtain diagnostic samples. A variety of specimen types may be obtained, including bronchial washes or brushes, protected specimen brushing, bronchoalveolar lavage, and transbronchial biopsies. Bronchoscopy has been applied in three primary clinical settings, including the immunocompromised host, especially human immunodeficiency virus-infected and organ transplant patients; ventilator-associated pneumonia; and severe, nonresolving community- or hospital-acquired pneumonia in nonventilated patients. In each clinical setting, and for each specimen type, specific laboratory protocols are required to provide maximal information. These protocols should provide for the use of a variety of rapid microscopic and quantitative culture techniques and the use of a variety of specific stains and selective culture to detect unusual organism groups.

Original languageEnglish (US)
Pages (from-to)533-558
Number of pages26
JournalClinical microbiology reviews
Volume7
Issue number4
DOIs
StatePublished - Oct 1994

ASJC Scopus subject areas

  • Epidemiology
  • Immunology and Microbiology(all)
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

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