Diagnostic fibreoptic bronchoscopy in the immunocompromised host with pulmonary infiltrates

fibreoptic bronchoscopy in the immunocompromised host with pulmonary infiltrates. Nineteen immunocompromised patients with pulmonary infiltrates underwent diagnostic fibreoptic bronchoscopy with transbronchial forceps and brush biopsy. A specific diagnosis was obtained in 21/25 procedures (10/11 focal lesions and 11/14 diffuse lesions). The most common diagnosis was infection, and organisms isolated included bacteria, fungi, Pneumocystis carinii, and herpes simplex. A pneumothorax requiring tube drainage occurred in two cases and mild lung parenchymal bleeding was noted in two others. It is concluded that fibreoptic bronchoscopy with forceps and brush biopsy can be performed safely with an excellent diagnostic yield in immunocompromised hosts with lung lesions. Supplemental oxygen should be administered during fibreoptic procedures in these patients and platelet transfusions should be given when thrombocytopenia is present. Since its introduction in 1968, flexible fibreoptic bronchoscopy has been widely employed in the evaluation and management of patients with pul-monary disorders (Khan et al., 1976). The pro