Prognostic value of bronchoalveolar lavage in patients with non-HIV pneumocystis pneumonia

Intern Med. 2014;53(11):1113-7. doi: 10.2169/internalmedicine.53.0520. Epub 2014 Jun 1.


Objective: Non-HIV patients with pneumocystis pneumonia (PCP) have a poor prognosis. We aimed to evaluate the prognostic factors for in-hospital mortality in terms of the clinical findings, including the results of bronchoalveolar lavage fluid (BALF)-analyses, in non-HIV PCP patients.

Methods: We retrospectively reviewed non-HIV PCP patients diagnosed using bronchoalveolar lavage between April 2006 and July 2012. For patients with a poor respiratory status, noninvasive positive pressure ventilation (NPPV) was used during the bronchoalveolar lavage (BAL) procedure. Data regarding demographics, laboratory findings and the prognosis were evaluated.

Results: A total of 29 non-HIV PCP patients were analyzed. NPPV was carried out safely and successfully in 12 patients during the BAL procedure. Twelve patients (41%) died. The multivariate logistic regression analysis identified only BALF neutrophilia to be a significant prognostic factor determining in-hospital mortality. The log-rank test showed that the patients with BALF neutrophilia (≥ 31%) had a significantly lower survival rate than the other patients (p=0.001).

Conclusion: Only BALF neutrophilia was found to be a significant predictor of survival in patients with non-HIV PCP. Our data also emphasize the significance of performing BAL in such patients, as it provides both diagnostic and prognostic information.

MeSH terms

  • Adult
  • Aged
  • Bronchoalveolar Lavage Fluid / cytology*
  • Bronchoalveolar Lavage Fluid / microbiology
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Neutrophils*
  • Pneumocystis carinii / isolation & purification*
  • Pneumonia, Pneumocystis / diagnosis
  • Pneumonia, Pneumocystis / mortality
  • Positive-Pressure Respiration
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate