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ArticleTitle	Usefulness of Bronchoalveolar Lavage for the Diagnosis and Treatment of Refractory Pneumonia in a Patient with Kostmann Syndrome, a Severe Congenital Neutropenia
AuthorList	Takashi Chiba, Jun Hayakawa, Takahiro Ueda, Makoto Migita, Miho Maeda, Takehide Imai, Masato Takase, Masatoshi Hida and Yoshitaka Fukunaga
Affiliation	Department of Pediatrics, Nippon Medical School
Language	EN
Volume	68
Issue	4
Year	2001
Page	340-343
Received	April 11, 2001
Accepted	May 1, 2001
Keywords	Bronchoalveolar lavage (BAL), Kostmann syndrome
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.
Correspondence to	Takashi Chiba, MD, PhD, Department of Pediatrics, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan t-chiba@nms.ac.jp