Abstract
Aim: Pulmonary infections are frequent in hematological malignancies. We evaluated the value of bronchoalveolar lavage (BAL) in determining the etiology of pulmonary infections in patients with hematologic malignancies
Methods: Patients with hematological malignancy who had undergone BAL for pulmonary infection diagnosis between May 2012-2014 were evaluated for microbiological results.
Results: Sixty procedures were performed to 51 patients whose mean age was 54. NHL was the most frequent underlying disease (n=25, 49%). Neutrophil count was below 500 only in 7 patients (12%). Twenty patients died (33%) in the follow-up. Diffuse and focal involvement were present in 40(67%) and 20(33%) of the patients respectively. Consolidation, nodule and ground glass density were determined in 25(42%), 20(33%) and 15(25%) respectively. Fungal cultures were positive in 9, bacterial cultures were positive in 16 and both were positive in 4 of the patients. Overall, BAL had a diagnostic utility in 21(35%) of the patients. The most frequent agents were Pseudomonas aeruginosa (n=4,7%), Klebsiella (n=4,7%), Acinetobacter (n=4,7%) and Candida glabrata (n=3,%5). Within 51 patients who had undergone micobacteriological cultures, M. tuberculosis was not determined, however in 4; nontuberculosis mycobacteria was positive. Neutropenic 5 (71%) and nonneutropenic 15(28%) patients died (p=0.036). Bacteriology positivity was determined in 9 (45%) of the patients with focal and 7(18%) of the patients with diffuse radiological involvement.
Conclusion: In patients with haemotological malignancies BAL had a high diagnostic yield for pulmonary infection diagnosis especially for focal involvement (p=0.023).
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