Objective: To report our experience with flexible fiberoptic bronchoscopy with bronchoalveolar lavage in children with the acquired immunodeficiency syndrome and acute lower respiratory tract disease.
Design: Retrospective study.
Setting: Children's Medical Center of Brooklyn, NY, a tertiary-level inner-city hospital.
Participants: Eighty-five children with acquired immunodeficiency syndrome and acute lower respiratory tract disease.
Intervention: One hundred five flexible fiberoptic bronchoscopies with bronchoalveolar lavages.
Measurements/main results: Infective agents were recovered in 88 procedures (84%). Potentially pathogenic bacteria were identified in 56 (56.6%) of 99 procedures. Viruses were found in 28 (29%) of 96 lavages, and fungi in 37 (41.6%) of 89 specimens. Pneumocystis carinii was identified in 22 (22.2%) of 99 specimens. Mycobacteria were isolated from 14 (14%) of 100 specimens. A serious complication occurred in only one procedure (0.95%).
Conclusion: Flexible fiberoptic bronchoscopy with bronchoalveolar lavage is a safe and effective diagnostic procedure that identified infective agents in 80% of children with acquired immunodeficiency syndrome and concomitant acute lower respiratory tract disease.