Etiologic Diagnosis of Focal Pulmonary Infection in Immunocompromised Patients by Fluoroscopically Guided Percutaneous Needle Aspiration

Abstract

Fluoroscopically guided percutaneous needle aspiration of focal pulmonary lesions was performed in 108 presumed [bacterial or fungal] infectious episodes in 82 immunocompromised patients in whom prior diagnostic studies, including transtracheal aspiration, were negative or inconclusive. Of the lesions, 2/3 were 4 cm or smaller. Single (61/79) or multiple (18/79) organisms were recovered for a diagnostic yield of 73% (79/108). Complications were pneumothorax (26%), half of which required tube drainage, and limited hemoptysis (3%). This technique can be quickly performed and frequently repeated with existing personnel and equipment in institutions currently employing it for suspected pulmonary neoplasm. It is a productive study in the evaluation of opportunistic pneumonia.