The Role of Bronchoalveolar Lavage in the Microbiological Diagnosis of Pneumonia in Patients with Haematological Malignancies

Abstract

In the aetiological diagnosis of pulmonary infections in patients affected by haematological malignancies we evaluated the utility of bronchoalveolar lavage (BAL). One hundred and twenty-seven BAL were performed in 119 patients. In our series, we identified the agent of pneumonia in 53.5% of episodes with the best results in aspergillosis, very common in these patients. The previous empirical anti-infective treatment was modified in 14 episodes (11%). The procedure was generally well tolerated and only one patient bled. We maintain that BAL is a useful diagnostic tool for detecting the agents of pulmonary infections in patients with haematological malignancies, especially when the routine microbiological procedures fail, and it also represents a good alternative to more invasive procedures.

Pneumonia in Acute Leukemia Patients During Induction Therapy: Experience in a Single Institution

“…mucositis, due to cytotoxic therapy has assumed greater importance with the use of cytarabine and anthracyclines [5 -8]. The diagnosis of pneumonia can be difficult for many reasons: an impaired inflammatory response can reduce the clinical or radiological signs; an etiological diagnosis by biopsy of pulmonary infiltrate is difficult to obtain because the necessary invasive investigation pose the risk of hemorrhage due to thrombocytopenia [9,10].…”

Bronchoalveolar lavage in immunocompromised patients with haematological malignancy – value of new microbiological methods

“…In order to obtain appropriate specimens for microbiological examination, bronchoalveolar lavage (BAL) performed by fiberoptic bronchoscopy has become a routine tool in haematology units in the diagnostics of pulmonary infections. According to prior reports, the diagnostic yield of BAL for the aetiology of pulmonary infiltrates in patients with haematological malignancy has varied between 31% and 80% (1–13). In most of these previous studies, the microbiological methods used have involved mainly bacterial, viral and fungal cultures.…”

Filamentous Fungi Infection in Patients with Myelodysplastic Syndrome. A Report of Twelve Cases

“…However, in literature, the sensitivity of BAL culture in the diagnosis of probable IFI is reported to range from 0 to 80%. This may be due to the timing of the BAL or to the technical approach [23]. In our experience, BAL was diagnostic in 3/4 cases.…”