Usefulness of Bronchoalveolar Lavage for the Diagnosis and Treatment of Refractory Pneumonia in a Patient with Kostmann Syndrome, a Severe Congenital Neutropenia

Takashi Chiba; Jun Hayakawa; Takahiro Ueda; Makoto Migita; Miho Maeda; Takehide Imai; Masato Takase; Masatoshi Hida; Yoshitaka Fukunaga

doi:10.1272/jnms.68.340

Reports on Experiments and Clinical Cases

Usefulness of Bronchoalveolar Lavage for the Diagnosis and Treatment of Refractory Pneumonia in a Patient with Kostmann Syndrome, a Severe Congenital Neutropenia

Takashi Chiba, Jun Hayakawa, Takahiro Ueda, Makoto Migita, Miho Maeda, Takehide Imai, Masato Takase, Masatoshi Hida, Yoshitaka Fukunaga

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Keywords: Bronchoalveolar lavage (BAL), Kostmann syndrome

JOURNAL FREE ACCESS

2001 Volume 68 Issue 4 Pages 340-343

DOI https://doi.org/10.1272/jnms.68.340

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Abstract

An 11-year-old girl with Kostmann syndrome developed refractory pneumonia. Culture of oral discharge, throat-swab specimens, and blood could not identity the causative organism, and systemic antimicrobial therapy failed to achieve improvement. We then performed diagnostic bronchoalveolar lavage (BAL) and culture of BAL fluid (BALF) yielded Pseudomonas aeruginosa. Therapeutic BAL using gentamicin produced a striking improvement of her pneumonia.
Conclusion: In immunocompromised children with pneumonia, BAL helps to identify the causative organism. If the patient is unresponsive to systemic antimicrobial therapy, BAL using antimicrobial agents is also worth trying.

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