Title The diagnostic role of fiberoptic bronchoscopy in immunocompromised patients with pulmonary diseases

Fifty-six bronchoscopies were carried out for the diagnosis of pulmonary diseases in 50 immunocompromised patients with various underlying diseases. In 30 of these patients, bronchoscopy provided useful findings. The diagnostic sensitivities (positive/procedures) for transbronchial lung biopsy bronchoalveolar lavage, aspiration of intra-bronchial sputum and brushing were 55.1%, 29.4%, 8.3% and 0%, respectively. Overall diagnostic sensitivity was higher for non-infectious diseases than for infectious ones. Also, there was a tendency for the diagnostic sensitivity to be higher in cases whose pulmonary infiltrates were extensive. In two samples of lavage fluid positive for the isolation of cytomegalovirus, the virus was not significant etiologically. Complications from bronchoscopy occurred in nine patients, but were not serious. However, no prolonged patient survival was noted with the use of diagnostic bronchoscopy. We consider that bronchoscopy is a safe method for the diagnosis of pulmonary diseases in immunocompromised patients, but that further studies are required in order to confirm the clinical significance of this procedure.