naa a22 4500 510741401 CHVBK 20180411083029.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s11845-012-0852-3 doi (NATIONALLICENCE)springer-10.1007/s11845-012-0852-3 Utility of bronchoalveolar lavage in the diagnosis of pulmonary infection in children with haematological malignancies [Elektronische Daten] [U. Rao, A. Piccin, A. Malone, K. O'Hanlon, F. Breatnach, A. O'Meara, M. McDermott, K. Butler, N. O'Sullivan, J. Russell, A. O'Marcaigh, O. Smith] Background: Fibre-optic bronchoscopy with bronchoalveolar lavage (BAL) is a safe procedure and is associated with low morbidity and mortality in immunocompromised children. Although many studies have highlighted the advantages of positive BAL results in the diagnosis of pulmonary infections, there have been few reports examining the impact of a negative BAL result on clinical management in immunocompromised children on empiric broad-spectrum antimicrobial therapy. Aim: The aim of this study was to evaluate BAL in the diagnosis of pulmonary infections in children with haematological malignancies who develop pneumonia unresponsive to empiric antimicrobial therapy, and also to determine whether a negative BAL result contributed to the clinical management of these patients. Materials and methods: A retrospective review of 44 BAL procedures performed in 33 children with haematological malignancy diagnosed and treated at Our Lady's Children Hospital, Crumlin, Dublin 12, Ireland, over a 10-year period was carried out. Results: We identified a pathogen causing pneumonia in 24 of 44 BAL procedures (54.5%). The BAL procedure resulted in modification of antimicrobial treatment after 20 of 24 procedures with positive results (83.3%) in 16 of 20 patients (80%). Management was changed after 8 of 20 procedures with negative results (40%) in 8 of 18 patients (44.4%). The procedure was well tolerated in all patients. Conclusions: Our study supports the use of bronchoscopy with BAL as a diagnostic intervention in this patient population. We consider BAL a safe procedure from which both positive and negative results contribute to the patient's clinical management. Royal Academy of Medicine in Ireland, 2012 Children nationallicence Bronchoalveolar lavage nationallicence Pulmonary disease nationallicence Haematologicalmalignancies nationallicence Antimicrobial therapy nationallicence Rao U. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Piccin A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Malone A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut O'Hanlon K. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Breatnach F. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut O'Meara A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut McDermott M. Department of Histopathology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Butler K. Department of Infectious Diseases, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut O'Sullivan N. Department of Microbiology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Russell J. Department of Otolaryngology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut O'Marcaigh A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Smith O. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut Irish Journal of Medical Science Springer-Verlag 182/2(2013-06-01), 177-183 0021-1265 182:2<177 2013 182 11845 https://doi.org/10.1007/s11845-012-0852-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11845-012-0852-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rao U. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- Piccin A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- Malone A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- O'Hanlon K. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- Breatnach F. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- O'Meara A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- McDermott M. Department of Histopathology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- Butler K. Department of Infectious Diseases, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- O'Sullivan N. Department of Microbiology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- Russell J. Department of Otolaryngology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- O'Marcaigh A. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 700 1- Smith O. Departments of Haematology and Oncology, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland aut NATIONALLICENCE 773 0- Irish Journal of Medical Science Springer-Verlag 182/2(2013-06-01), 177-183 0021-1265 182:2<177 2013 182 11845 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer