Do you favor timely bronchoscopy for diagnostics over close surveillance in mildly symptomatic patients with CT findings suspicious for NTM infection who are not able to expectorate?
Answer from: at Academic Institution
Yes, I do favor FOB to obtain BAL in symptomatic patients with suspected NTM.
Good comments. I think you would also need to clarify what "mildly symptomatic" means. If they have a dry cough, is that sufficient to label them? Imaging would have to be, correspondingly, a nodular/bronchiectacic pattern to fall into the mild category, not cavitary.
In that case, initiation of ai...
It depends on what is meant by "mildly symptomatic." While bronchoscopy with lavage is considered low risk, I have personally seen significant complications arise in this patient population (spreading of infection/inflammatory response, hypoxia, and new areas of cavitation).
If a patient is d...
I agree with Dr. @Saad. If the patient otherwise meets criteria for treatment (CT scan consistent with disease and symptoms of infection) then the most definitive way to determine if the patient has NTM disease is bronchoscopy/BAL.
However, for patients who are ambivalent about treatment or broncho...
Comments
at Northern Virginia Pulmonary And Critical Care Associates Pc Should do bronchoscopy if you would start treatmen...
at Sutter Medical Center Sacramento I agree with Dr. @Bloom.
at Alaska Area Native Health Service Most patients undergo CT because they have experie...
at Yale New Haven Hospital Saint Raphael Campus I will occasionally recommend bronchoscopy if ther...
at Overlake Medical Clinics Infectious Disease I agree with Dr. @Clark regarding discontinuing IC...