Chest, Vol 97, 576-582, Copyright © 1990 by American College of Chest Physicians

ARTICLES

Diagnostic fiberoptic bronchoscopy and protected brush culture in patients with community-acquired pneumonia

A Ortqvist, M Kalin, L Lejdeborn and B Lundberg
Department of Infectious Diseases, Karolinska Institute, Stockholm, Sweden.

A model for performing fiberoptic bronchoscopy as a supplement to noninvasive diagnostic methods, in patients with community-acquired pneumonia, was prospectively studied. Twenty-four patients underwent bronchoscopy, seven pilot patients and 17 of 277 (6 percent) consecutive patients with CAP. Indications for FOB were early therapy failure (less than or equal to 72h)(n = 7), late therapy failure (greater than 72h)(n = 11), or before start of antibiotic therapy in severely ill or immunocompromised patients (n = 6). Samples were obtained by aspiration of bronchial secretion and with a protected brush catheter from which quantitative cultures with a detection level of 10(4) colony forming units per ml were performed. Results concluded that FOB, with the use of quantitative PB-cultures, offered a safe and specific diagnostic tool, which on special indications, can be of great value in the management of patients with CAP.

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