Importance of flexible broncoscopy in immunocompromised children with pulmonary infections

INTRODUCTION Pulmonary infections are frequently seen in immunocomprimised children. AIMS 1. To determine the importance of FB and BAL analysis in showing the agent of pulmonary infected immunocompromised children. 2. To investigate the differences of agents and radiological findings between the pulmonary infections arised after BMT and other immunocompromised cases. 3. To evaluate the reliability of radiological findings in showing the agent. METARIALS AND METHODS FB and BAL analysis for 79 immunocompromised and pulmonary infected children are retrospectively studied and divided into two groups. Children in group I (n=61) are the primary or secondary immunosupressed patients applied FB and BAL because of pulmonary infections. Children in group II (n=18) are the patients applied FB and BAL because of pulmonary infections after BMT. RESULTS In BAL sample analysis, the microorganism was shown in 37 (60,6%) patients of group I and 7 (38,8%) patients of group II. When the microbiological agents compared, the bacterial growth in BAL samples was higher in group I (p=0,017). For the other agents there was no significant difference. No relation between HRCT findings and the agents shown in BAL could be found. After the analysis of all diagnostic tools related with FB, it was determined that 62/79 (78%) of all patients could be diagnosed. In 32/79 (%40) of all patients the agent was exactly shown and therapy changed. CONCLUSION Although FB is applied under empirical anti-microbiological therapy, the importance of BAL analysis in showing the agent of pulmonary infection in immunocompromised children and it9s contribution to diagnosis is found to be high.