[khanar]

Everybody knows that the best diagnostic and affirmative test for Pneumocystis jirovecii is bronchoalveolar lavage. This is what's said in FA and Kaplan notes.

But in Kaplan Qbank I face a question that mentioned induced sputum immunoflourescence is the diagnostic test of choice!

Are they right, or the Kaplan qbank is hallucinating on this issue

 

[ath.pantelis]

PJP Labs: Cysts and trophozoites of P jiroveci on methenamine silver or Giemsa stains of sputum or bronchoalveolar lavage fluid; direct immunofluorescent antibody on BAL fluid -- Source: Jawetz Medical Microbiology

"We conclude that examination of induced sputum is a rapid, sensitive, and inexpensive method for diagnosing P. carinii pneumonia and that indirect immunofluorescence is a practical and highly sensitive staining technique for establishing this diagnosis."
Source: NEJM 318:589-593, March 10 1988(!!!).

"Sputum induction with hypertonic saline has a diagnostic yield of 50 to 90 percent and should be the initial procedure used to diagnose pneumocystis pneumonia, particularly in patients with AIDS. If the initial specimen of induced sputum is negative for pneumocystis, then bronchoscopy with bronchoalveolar lavage should be performed."

Source: NEJM 350:2487-2498, June 10 2004 (much better!)

I don't know whether these are very helpful, but they set a point to start from!

 

[khanar]

@ ath.pantelis
Woow what a great convincing answer, thank you dear.

 

[vvijayy]

nothing is impossible

nothing is impossible