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Introduction <p>Non-resolving pneumonia (NRP) poses a significant diagnostic challenge, often requiring advanced investigations for accurate identification of underlying causes. Fiber-optic bronchoscopy (FOB), along with bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB), is increasingly recognized for its diagnostic utility.</p> Patients and methods <p>This prospective observational study was designed to evaluate the role of FOB in determining the aetiology of NRP among patients at a tertiary care hospital in Kashmir. It was conducted on 70 patients diagnosed with NRP between December 2018 and November 2020. Clinical, radiological, and microbiological investigations were performed, followed by FOB. Findings from BAL and TBLB were analyzed to determine diagnostic outcomes.</p> Results <p>The mean age of participants was 55.9 ± 17&#xa0;years, with males comprising 58.6%. Pulmonary tuberculosis (38.6%) was the most common etiology, followed by malignancy (24.3%), bacterial pneumonia (20%), and fungal pneumonia (8.5%). Squamous cell carcinoma (20%) was the predominant malignancy, especially in smokers. The overall diagnostic yield of FOB was 91.4%. No major procedural complications were reported.</p> Conclusion <p>FOB, combined with BAL and TBLB, is a highly effective diagnostic tool for NRP, offering valuable insights into infectious and non-infectious etiologies. It is particularly beneficial for diagnosing pulmonary tuberculosis and centrally located malignancies, highlighting its significance in improving patient outcomes. This study emphasizes the importance of a comprehensive diagnostic approach in cases of NRP, especially in resource-limited settings.</p>

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Unveiling the hidden causes: the crucial role of fiber optic bronchoscopy in diagnosing non-resolving pneumonia - a prospective study conducted in a tertiary care hospital of north India

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  • 发表日期：

    2025年5月31日

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  • Amir Abdullah Dar,
  • Syed Mudasir Qadri,
  • Saleem Javaid Wani,
  • Ghulam Nabi Dhobi,
  • Vivek Kumar,
  • Nazia Mehfoz,
  • Sonaullah Shah,
  • Fayaz Ahmad Bhat

摘要

Introduction

Non-resolving pneumonia (NRP) poses a significant diagnostic challenge, often requiring advanced investigations for accurate identification of underlying causes. Fiber-optic bronchoscopy (FOB), along with bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB), is increasingly recognized for its diagnostic utility.

Patients and methods

This prospective observational study was designed to evaluate the role of FOB in determining the aetiology of NRP among patients at a tertiary care hospital in Kashmir. It was conducted on 70 patients diagnosed with NRP between December 2018 and November 2020. Clinical, radiological, and microbiological investigations were performed, followed by FOB. Findings from BAL and TBLB were analyzed to determine diagnostic outcomes.

Results

The mean age of participants was 55.9 ± 17 years, with males comprising 58.6%. Pulmonary tuberculosis (38.6%) was the most common etiology, followed by malignancy (24.3%), bacterial pneumonia (20%), and fungal pneumonia (8.5%). Squamous cell carcinoma (20%) was the predominant malignancy, especially in smokers. The overall diagnostic yield of FOB was 91.4%. No major procedural complications were reported.

Conclusion

FOB, combined with BAL and TBLB, is a highly effective diagnostic tool for NRP, offering valuable insights into infectious and non-infectious etiologies. It is particularly beneficial for diagnosing pulmonary tuberculosis and centrally located malignancies, highlighting its significance in improving patient outcomes. This study emphasizes the importance of a comprehensive diagnostic approach in cases of NRP, especially in resource-limited settings.