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Enhancing respiratory disease diagnosis by bronchoalveolar lavage in Kashmir: an audit of findings
  1. Javeed Iqbal Bhat1,
  2. Zubair M Tramboo1,
  3. Tajamul Hussain Shah2,
  4. Bashir Ahmad Charoo1,
  5. Iqbal Ahmad Qazi1
  1. 1 Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
  2. 2 Department of Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
  1. Correspondence to Dr Javeed Iqbal Bhat, Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir 190011, India; drjaveediqbal{at}gmail.com

Abstract

Objective To study bronchoalveolar lavage (BAL) findings in various respiratory diseases in children in Kashmir India.

Design Prospective observational study.

Setting Paediatric department of the tertiary care hospital.

Patients Children of both genders from 1 month to 17 years of age

Intervention All studied patients underwent flexible bronchoscopy and BAL.

Outcome measure To observe the BAL findings in various respiratory diseases in the studied population.

Results A total of 283 patients underwent BAL procedure. The positive BAL report was received in 131 (46%) patients. Out of these, 55 (42%) patients had positive BAL culture/ microscopy for different bacterial (50) and fungal species (Candida spp (3), Mucormycosis (1) and Aspergillus (1)). MTB was isolated in 25 (19%) patients. Twenty-three (17.5%) patients had bronchoalveolar lavage fluid (BALF) positive for pulmonary hydatidosis. Foamy macrophages were seen in 13 patients, significant eosinophilia in nine patients and hemosiderin-laden macrophages were seen in three patients.

Conclusion We found BALF a very useful sample for the evaluation of many infective and non-infective respiratory diseases in our region, which otherwise lacks high end diagnostics. 46% of our patients had some abnormalities in the BAL specimen. It provided us with valuable information regarding organism profile and drug sensitivity in case of lung infection. BALF analysis was also found useful in the diagnosis of some non-infective pulmonary disorders like acute eosinophilic pneumonia, aspiration syndromes and bronchial asthma.

  • Respiratory Medicine
  • Microbiology

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors JIB and ZMT conceived the idea of the study and wrote the manuscript; JIB and THS were involved in the sample collection; IAQ conducted the data analysis; BAC supervised the implementation of the study and contributed to the writing of the manuscript. JIB is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.