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Pulmonary complications are a significant cause of morbidity and mortality in immunocompromised haemato-oncology patients, with invasive fungal infection being one of the commonest. Chest computed tomography (CT) with bronchoalveolar lavage (BAL) for further investigation of new pulmonary changes identified on CT is frequently used to investigate patients with neutropenic fever unresponsive to broad-spectrum antibiotics. However, studies of BAL are conflicting, with diagnostic yields of 15– 80 % (Milburn et al., 1987; Saito et al., 1988; Peikert et al., 2005), whilst its role in diagnosing non-infectious aetiologies is limited. Complication rates approach 15 % in haematology patients and some studies have failed to demonstrate a beneficial impact on patient outcome in response to BAL findings (White et al., 1997; Murray et al., 2001). The optimum role of BAL in the diagnostic pathway of this high-risk population remains unclear.

journal of medical microbiology/journal of medical microbiology

Role of bronchoalveolar lavage in evaluating new pulmonary infiltrates on computed tomography in haematology patients with fever unresponsive to broad-spectrum antibiotics