INVASIVE DIAGNOSTIC-TECHNIQUES FOR PNEUMONIA - PROTECTED SPECIMEN BRUSH, BRONCHOALVEOLAR LAVAGE, AND LUNG-BIOPSY METHODS

The diagnosis of pneumonia is made by a combination of special techniq ues and cultures for organisms. Analysis of respiratory secretions inc ludes various procedures to identify the presence of organisms and the ir concentration. Moreover, the quality of the specimen is assessed by exclusion of significant contamination with oropharyngeal flora, whic h may affect the specificity of bacterial cultures. Invasive procedure s have been developed to collect secretions directly from the involved lower respiratory tract while minimizing contamination with bacteria colonizing the upper airways. These techniques, which are reviewed in this article, include bronchoscopic techniques, some nonbronchoscopic methods, transbronchial lung biopsy, and open-lung biopsy.