Etiologic diagnosis of pneumonia in HIV-AIDS patients. Usefulness of fibrobronchoscopy

Objective: to assess the usefulness of fiberoptic bronchoscopy in the etiologic diagnosis of pulmonary infiltrates in patients with AIDS.

Methods: in 25 patients with AIDS and pneumonia, 31 fiberoptic bronchoscopies with bronchoalveolar lavage were performed; in 11 occasions, a transbronchial biopsy was also performed.

Results: in 24 of the 31 procedures (77%) an etiologic diagnosis was made. There were 7 false negative results; in two of these patients, a repeated examination allowed an etiologic diagnosis. The etiologies of the infiltrates were pyogenic bacteria in 14 cases. Pneumocystis carinii in 9, mycobacteria in 3, cytomegalovirus in one and a lymphocytic interstitial pneumonia in one. In 5 patients, the association of two or more etiological agents was observed. Except one case, all patients had a good response to specific treatments. There were no complications attributed to the bronchoscopic procedure.

Conclusions: fiberoptic bronchoscopy and bronchoalveolar lavage are safe and effective procedures for the etiologic diagnosis of pulmonary infiltrates in patients with AIDS.