Enhancing respiratory disease diagnosis by bronchoalveolar lavage in Kashmir: an audit of findings

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.