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M9490649.TXT
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1994-09-24
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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
protected by Copyright Law (Title 17, U.S.Code).