Document 0649
 DOCN  M9490649
 TI    Bronchoscopic diagnosis of pulmonary coccidioidomycosis. Comparison of
       cytology, culture, and transbronchial biopsy.
 DT    9411
 AU    DiTomasso JP; Ampel NM; Sobonya RE; Bloom JW; Medical Service, VAMC,
       Tucson, AZ 85723.
 SO    Diagn Microbiol Infect Dis. 1994 Feb;18(2):83-7. Unique Identifier :
       AIDSLINE MED/94340910
 AB    The results of all fiberoptic bronchoscopic examinations that detected
       Coccidioides immitis at two medical centers in an area endemic for
       coccidioidomycosis were retrospectively reviewed. Coccidioides immitis
       was detected by cytologic examination of fluid from either bronchial
       wash or bronchoalveolar lavage (BAL) fluid in eight (42%) of 19
       HIV-infected patients and in 11 (31%) of 35 patients without HIV
       infection (P = 0.627). In all cases, the fluid samples grew C. immitis.
       The median time to positive identification of the fungus was 25 days.
       Preliminary identification of C. immitis, however, took a median of 3.5
       days (range, 2-9 days) in 10 patients on whom these data were available.
       Transbronchial biopsy was performed simultaneously in eight cases, and
       C. immitis was identified by morphologic examination in all eight. These
       results indicate that cytologic examination of bronchial wash or BAL
       fluid from patients with and without HIV infection is diagnostic in less
       than half of cases of pulmonary coccidioidomycosis. Culture of the same
       fluid appears to be more sensitive than cytologic examination in
       establishing this diagnosis.
 DE    Adult  AIDS-Related Opportunistic Infections/DIAGNOSIS  Biopsy
       Bronchi/PATHOLOGY  Bronchoalveolar Lavage Fluid  Bronchoscopy
       Coccidioides/GROWTH & DEVELOPMENT/*ISOLATION & PURIF
       Coccidioidomycosis/*DIAGNOSIS/MICROBIOLOGY/PATHOLOGY  Comparative Study
       Human  Lung Diseases/*DIAGNOSIS/MICROBIOLOGY/PATHOLOGY  Retrospective
       Studies  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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