Bronchoalveolar lavage for diagnosis of fungal disease. Five years' experience in a southern United States rural area with many blastomycosis cases.

OBJECTIVE

To determine the relative frequency of Blastomyces dermatitidis among other microorganisms in bronchoalveolar lavage (BAL) specimens.

STUDY

DESIGN

The study group consisted of 208 BAL specimens received from 192 patients from March 1988 to August 1993.

RESULTS

Forty-seven specimens from 42 patients were positive for pathogenic microorganisms, and 2 other specimens were diagnostic of malignancy. Pneumocystis carinii (23 specimens) was the most common microorganism found in the specimens. Candida spp (10 specimens) was the second most common microorganism, and B dermatitidis (5 specimens) was the third. Cryptococcus neoformans (3 patients), Histoplasma capsulatum (2 patients) and Conidiobolus coronatus (1 patient) were the other fungi detected in BAL. Acid-fast bacilli, cytomegalovirus and herpes simplex virus were also found (1 patient each). Several patients had more than one organism.

CONCLUSION

B dermatitidis was the third most common microorganism found in BAL specimens at our hospital.