Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
ORIGINAL ARTICLES
Prognostic Value of Bronchoalveolar Lavage in Patients with Non-HIV Pneumocystis Pneumonia
Koji TamaiRyo TachikawaKeisuke TomiiKazuma NagataKojiro OtsukaAtsushi NakagawaKyoko OtsukaTakeshi MatsumotoKazuya MondenJumpei TakeshitaKosuke TanakaTakahisa KawamuraTakehiro OtoshiDaichi Fujimoto
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JOURNAL OPEN ACCESS

2014 Volume 53 Issue 11 Pages 1113-1117

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Abstract

Objective Non-HIV patients with pneumocystis pneumonia (PCP) have a poor prognosis. We aimed to evaluate the prognostic factors for in-hospital mortality in terms of the clinical findings, including the results of bronchoalveolar lavage fluid (BALF)-analyses, in non-HIV PCP patients.
Methods We retrospectively reviewed non-HIV PCP patients diagnosed using bronchoalveolar lavage between April 2006 and July 2012. For patients with a poor respiratory status, noninvasive positive pressure ventilation (NPPV) was used during the bronchoalveolar lavage (BAL) procedure. Data regarding demographics, laboratory findings and the prognosis were evaluated.
Results A total of 29 non-HIV PCP patients were analyzed. NPPV was carried out safely and successfully in 12 patients during the BAL procedure. Twelve patients (41%) died. The multivariate logistic regression analysis identified only BALF neutrophilia to be a significant prognostic factor determining in-hospital mortality. The log-rank test showed that the patients with BALF neutrophilia (≥31%) had a significantly lower survival rate than the other patients (p=0.001).
Conclusion Only BALF neutrophilia was found to be a significant predictor of survival in patients with non-HIV PCP. Our data also emphasize the significance of performing BAL in such patients, as it provides both diagnostic and prognostic information.

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© 2014 by The Japanese Society of Internal Medicine
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