What is the role of bronchoscopy in the workup of fungal pneumonia?

Updated: Jun 21, 2019
  • Author: Romeo A Mandanas, MD, FACP; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Answer

Fiberoptic bronchoscopy (procedure of choice) is used to obtain bronchial lavage specimens for staining and culture techniques and transbronchial biopsy specimens for identification of fungal tissue invasion. This procedure reveals positive results in 75-90% of endemic mycoses, shows a 50-90% yield in cryptococcal disease, and shows varying yields in Aspergillus and Candida infections, for which clinical correlation is still important.

The yield of isolating Aspergillus from bronchoalveolar lavage specimens may also depend upon the underlying condition and the leukocyte count of the patient. One study demonstrated that there was little value in doing bronchoscopy and bronchoalveolar lavage in acute leukemia patients with leukocyte counts of less than 100/µL compared with nonleukemia patients such as allogeneic hematopoietic stem cell recipients. [33]


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