Document 0311
 DOCN  M9460311
 TI    Sputum induction compared with bronchoalveolar lavage by Ballard
       catheter to diagnose Pneumocystis carinii pneumonia [see comments]
 DT    9404
 AU    Bustamante EA; Levy H; Department of Medicine, University of New Mexico,
       Albuquerque.
 SO    Chest. 1994 Mar;105(3):816-22. Unique Identifier : AIDSLINE MED/94178008
 CM    Comment in: Chest 1994 Mar;105(3):650-2
 AB    Specimens from sputum induction (SI) are often of insufficient volume or
       have poor diagnostic yield for the diagnosis of Pneumocystis carinii
       pneumonia (PCP). The Ballard catheter for bronchoalveolar lavage (BAL)
       is a disposable BAL device which is passed transnasally into the airway
       and wedged by sensation. Thirty consecutive episodes (21 inpatient and 9
       outpatient) in 28 patients positive for HIV (15 with AIDS) were studied
       with SI and BAL at a tertiary-care university hospital. Six SIs yielded
       no specimen, and six were judged inadequate for investigation by the
       laboratory. The BAL return averaged 53 ml (range, 10 to 77 ml), and all
       specimens were excellent quality based on microscopy. Of the 10 patients
       (33 percent) who were PCP-positive on BAL, only 2 (6.9 percent) were
       detected by SI (McNemar p = 0.0078). Of 12 patients in whom SI was
       unobtainable or inadequate, 6 were positive for PCP on BAL. Two adequate
       specimens from SI were negative, but BAL specimens were positive for
       PCP. No patients had specimens that were positive for PCP on SI who had
       negative BAL specimens. The adequacy of the specimen and the PCP
       diagnosis with BAL were statistically superior to SI (McNemar p =
       0.007). The Ballard BAL catheter allows easy transnasal access to the
       airway and safe BAL, with a statistically significant superior yield of
       specimens when compared to SI.
 DE    AIDS-Related Opportunistic Infections/*DIAGNOSIS  Bronchoalveolar Lavage
       Fluid/*MICROBIOLOGY  Catheterization/ECONOMICS/*INSTRUMENTATION
       Comparative Study  Costs and Cost Analysis  Female  Human
       Irrigation/METHODS  Male  Pneumonia, Pneumocystis carinii/*DIAGNOSIS
       Sensitivity and Specificity  Specimen Handling/METHODS
       Sputum/*MICROBIOLOGY  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).