TY - JOUR T1 - Virological analysis on bronchoalveolar lavage fluid (BALF): Diagnostic yield and indications JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2520 AU - Jean-Sébastien Poineuf AU - Stéphane Jouneau AU - Sophie Minjolle AU - Pierre Tattevin AU - Philippe Delaval AU - Benoît Desrues Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2520.abstract N2 - Introduction: BAL is a major diagnostic tool in infectious lung diseases. Viral respiratory infections are a frequent cause of asthma and COPD exacerbations as well as severe pneumonia.Aims: To analyze the characteristics of subjects with positive virological analysis of BALF and to define the best indications.Methods: We retrospectively studied all virological analysis (immunofluorescence, viral culture and PCR) performed on BALF in 2008 at Rennes University Hospital, France. We compared characteristics of patients with positive vs negative virological analysis of BALF.Results: 232 BAL were performed in 212 patients. Seventy BAL were positive (30%), including 84 viruses: HSV1 (27), CMV (23), EBV (17), HHV6 (12), RSV (3), rhinovirus (1) and adenovirus (1). Immunocompromised patients represent 83% of all positive BAL. Immunosuppression (HIV patients, corticosteroids >10 mg/day for ≥ 3 weeks or immunosuppressive therapy) and ground glass attenuations on chest CT-scan were more present in patients with positive virological BALF compared to negative: respectively 82,9% vs 46,9%; p<0,0001 and 65,6% vs 43,7%; p=0,006. There were no significant differences in demographic and clinical criteria (age, gender, fever, dyspnea, cough, hemoptysis). Pneumonia in immunocompromised subjects was the most frequent indication of BALF viral analysis (55%) with a diagnostic yield of 44%. None of the 17 virological analysis of BALF performed for assessment of diffuse infiltrative lung disease was positive.Conclusion: Pneumonia in immunocompromised hosts seems to be the preferential indication of virological analysis of BALF, especially when chest CT-scan demonstrates ground-glass attenuations. ER -