Bronchial and bronchoalveolar lavage in diagnosis of subacute and chronic pneumonia in brazilian children

ORIGINAL ARTICLE

Bronchial and Bronchoalveolar Lavage in Diagnosis of Subacute and Chronic Pneumonia in Brazilian Children

Rosanna Vilardo Mannarino¹, Maria de Fatima Pombo March², Antonio Jose Ledo Alves da Cunha², Guilherme Milward³, Jose Guimaraes Gomes³, Clemax Couto Sant'Anna².

¹Pediatric and Neonatal Intensive Care Unit, Gaffree e Guinle University Hospital, Rio de Janeiro,
²Department of Pediatrics, School of Medicine, Federal University, Rio de Janeiro,
³Pediatric Respiratory Endoscopy Section, Fernandes Figueira Institute- Oswaldo Cruz Foundation..

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Abstract
Background: To describe the results of bronchoalveolar lavage (BAL) and bronchial lavage (BL) in the etiological diagnosis of chronic pneumonia in children in a pediatric tertiary center in Rio de Janeiro, Brazil.

Methods: Observational descriptive study consisting of children with chronic pneumonia. Fibre-optic bronchoscopy was done to collect BAL followed by BL. The collected materials were analyzed for cellularity and pathology, cultured for bacteria, fungi, viruses and M. tuberculosis. Material cultured for Gram-positive cocci (S. pneumoniae, S. pyogenes and Staphylococcus aureus) was positive if > 103 cfu/mL-1.

Results: Twenty two children were included in the study. Male: Female ratio was 14:8 with mean age of 3.5 years. In 7 (31.8%) patients, etiological diagnosis was determined by BAL and 4 (18.1%) by BL. Bacteria were isolated in 4 (18.1%) BAL and in 3 (13.6%) BL. Conclusion: BAL contributed most frequently for the etiological diagnosis of chronic pneumonia than BL. Both methods proved to be safe.

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