Evaluation of diagnostic outcomes of non-resolving pneumonia by fiberoptic bronchoscopy

Authors : MD Majeed Pasha, Kolla Vinod, Shivalinga Swamy Salimath, Sujith Halappa

DOI : 10.18231/2581-4222.2018.0016

Volume : 3

Issue : 2

Year : 0

Page No : 56-60

Background: Non-resolving pneumonia (NRP) is a cause of concern among treating physicians due to its diagnostic dilemma. Bronchoalveolar lavage (BAL) is an important tool in diagnosing non resolving pneumonia. This study was undertaken to evaluate non resolving pneumonia by fiberoptic bronchoscopy and BAL to find the etiological diagnosis.
Methodology: A prospective observational study was done at a tertiary care centre, Rajarajeshwari Medical College and Hospital Bangalore over the period of one and a half year. Total 64 cases of non-resolving pneumonia were included and patients were evaluated thoroughly by history, clinical examination, radiological tests like chest X-ray and CT-chest, laboratory investigations like white blood cell count, sputum culture and brochoscopic BAL culture were obtained in all patients.
Results: 64 patients enrolled in the study out of which 46 (71.87%) male and 18(28.125%) female, mean age of the patients was 52.6 ±11.2. unilateral lung involvement was in 48(75%) of the patients and right lung was most commonly involved in 39(60.93%) patients. The bronchoscopic findings of mucosal inflammation and purulent secretion were most common findings in 36(56.25%). Bacterial culture was positive in 52(81.25%) in BAL analysis, among that Klebsiellae pneumoniae was most common organism in 23(35.93%). BAL AFB smear was positive in 7(10.93%) and 9(14.06%) positive for CBNAAT test.
Conclusions: NRP is difficult to treat and diagnostic dilemma for physicians. Bronchoscopic interventions like BAL show significant results in etiological diagnosis of non-resolving pneumonia. Timely intervention of FOB BAL helps in treating patients of non-resolving pneumonia.

Keywords: Fiberoptic bronchoscopy; Non resolving pneumonia.


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