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Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection

BACKGROUND: The prognostic value of bronchoalveolar lavage (BAL) fluid analysis in non-human immunodeficiency virus (HIV)-infected patients with Pneumocystis jirovecii pneumonia (PJP) has not been well elucidated. We aimed to investigate the prognostic implication of BAL fluid analysis in non-HIV pa...

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Autores principales: Chung, Chiwook, Lim, Chae Man, Oh, Yeon-Mok, Hong, Sang Bum, Choi, Chang-Min, Huh, Jin Won, Lee, Sei Won, Lee, Jae Seung, Jo, Kyung-Wook, Ji, Wonjun, Park, Chan-Jeoung, Kim, Mina, Sung, Heungsup, Cho, Young-Uk, Cho, Hyo Sin, Kim, Ho Cheol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233854/
https://www.ncbi.nlm.nih.gov/pubmed/35754032
http://dx.doi.org/10.1186/s12890-022-02041-8
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author Chung, Chiwook
Lim, Chae Man
Oh, Yeon-Mok
Hong, Sang Bum
Choi, Chang-Min
Huh, Jin Won
Lee, Sei Won
Lee, Jae Seung
Jo, Kyung-Wook
Ji, Wonjun
Park, Chan-Jeoung
Kim, Mina
Sung, Heungsup
Cho, Young-Uk
Cho, Hyo Sin
Kim, Ho Cheol
author_facet Chung, Chiwook
Lim, Chae Man
Oh, Yeon-Mok
Hong, Sang Bum
Choi, Chang-Min
Huh, Jin Won
Lee, Sei Won
Lee, Jae Seung
Jo, Kyung-Wook
Ji, Wonjun
Park, Chan-Jeoung
Kim, Mina
Sung, Heungsup
Cho, Young-Uk
Cho, Hyo Sin
Kim, Ho Cheol
author_sort Chung, Chiwook
collection PubMed
description BACKGROUND: The prognostic value of bronchoalveolar lavage (BAL) fluid analysis in non-human immunodeficiency virus (HIV)-infected patients with Pneumocystis jirovecii pneumonia (PJP) has not been well elucidated. We aimed to investigate the prognostic implication of BAL fluid analysis in non-HIV patients with PJP. METHODS: The data of 178 non-HIV patients diagnosed with PJP based on the results of the polymerase chain reaction assay of BAL fluid specimens between April 2018 and December 2020 were retrospectively reviewed. The clinical characteristics, laboratory findings, and BAL fluid analysis results of patients who died within 90 days after hospital admission were compared. RESULTS: Twenty patients (11.2%) died within 90 days from admission. The neutrophil count in BAL fluid was significantly higher (median 22.0%, interquartile range [IQR] 2.0–46.0% vs. median 6.0%, IQR 2.0–18.0%, P = 0.044), while the lymphocyte count was significantly lower (median 24.0%, IQR 7.0–37.0% vs. median 41.0%, IQR 22.5–60.5%, P = 0.001) in the non-survivor group compared with that in the survivor group. In the multivariate analysis, the C-reactive protein level (odds ratio [OR] 1.093, 95% confidence interval [CI] 1.020–1.170, P = 0.011) and a BAL fluid lymphocyte count of ≤ 30% (OR 3.353, 95% CI 1.101–10.216, P = 0.033) were independently associated with mortality after adjusting for albumin and lactate dehydrogenase levels. CONCLUSION: A low lymphocyte count in BAL fluid may be a predictor of mortality in non-HIV patients with PJP. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-022-02041-8.
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spelling pubmed-92338542022-06-27 Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection Chung, Chiwook Lim, Chae Man Oh, Yeon-Mok Hong, Sang Bum Choi, Chang-Min Huh, Jin Won Lee, Sei Won Lee, Jae Seung Jo, Kyung-Wook Ji, Wonjun Park, Chan-Jeoung Kim, Mina Sung, Heungsup Cho, Young-Uk Cho, Hyo Sin Kim, Ho Cheol BMC Pulm Med Research BACKGROUND: The prognostic value of bronchoalveolar lavage (BAL) fluid analysis in non-human immunodeficiency virus (HIV)-infected patients with Pneumocystis jirovecii pneumonia (PJP) has not been well elucidated. We aimed to investigate the prognostic implication of BAL fluid analysis in non-HIV patients with PJP. METHODS: The data of 178 non-HIV patients diagnosed with PJP based on the results of the polymerase chain reaction assay of BAL fluid specimens between April 2018 and December 2020 were retrospectively reviewed. The clinical characteristics, laboratory findings, and BAL fluid analysis results of patients who died within 90 days after hospital admission were compared. RESULTS: Twenty patients (11.2%) died within 90 days from admission. The neutrophil count in BAL fluid was significantly higher (median 22.0%, interquartile range [IQR] 2.0–46.0% vs. median 6.0%, IQR 2.0–18.0%, P = 0.044), while the lymphocyte count was significantly lower (median 24.0%, IQR 7.0–37.0% vs. median 41.0%, IQR 22.5–60.5%, P = 0.001) in the non-survivor group compared with that in the survivor group. In the multivariate analysis, the C-reactive protein level (odds ratio [OR] 1.093, 95% confidence interval [CI] 1.020–1.170, P = 0.011) and a BAL fluid lymphocyte count of ≤ 30% (OR 3.353, 95% CI 1.101–10.216, P = 0.033) were independently associated with mortality after adjusting for albumin and lactate dehydrogenase levels. CONCLUSION: A low lymphocyte count in BAL fluid may be a predictor of mortality in non-HIV patients with PJP. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-022-02041-8. BioMed Central 2022-06-26 /pmc/articles/PMC9233854/ /pubmed/35754032 http://dx.doi.org/10.1186/s12890-022-02041-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Chung, Chiwook
Lim, Chae Man
Oh, Yeon-Mok
Hong, Sang Bum
Choi, Chang-Min
Huh, Jin Won
Lee, Sei Won
Lee, Jae Seung
Jo, Kyung-Wook
Ji, Wonjun
Park, Chan-Jeoung
Kim, Mina
Sung, Heungsup
Cho, Young-Uk
Cho, Hyo Sin
Kim, Ho Cheol
Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
title Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
title_full Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
title_fullStr Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
title_full_unstemmed Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
title_short Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
title_sort prognostic implication of bronchoalveolar lavage fluid analysis in patients with pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233854/
https://www.ncbi.nlm.nih.gov/pubmed/35754032
http://dx.doi.org/10.1186/s12890-022-02041-8
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