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 infectious episodes in 82 immunocompromised patients in whom prior diagnostic studies, including transtracheal aspiration, were negative to inconclusive. Two-thirds of the lesions 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, and is a productive study in the evaluation of "opportunistic pneumonia".