Role of Early Fiberoptic Bronchoscopy and Bronchoalveolar Lavage in Diagnosing Non-Resolving Pneumonia at a Tertiary Care Hospital

Pneumonia, a significant cause of morbidity and mortality globally, often presents diagnostic challenges due to unidentified etiologic agents. Non-resolving pneumonia, particularly, complicates clinical management, as standard antibiotic therapy may be ineffective. This study aimed to investigate the role of early bronchoscopy and bronchoalveolar lavage (BAL) in identifying causative agents in patients with non-resolving pneumonia at a tertiary care hospital. This observational cross-sectional study, conducted at DR. BRAMH, Raipur, from January 2023 to February 2024, included 140 patients presenting with pneumonia symptoms and radiographic findings. Fiberoptic bronchoscopy was performed on all participants, with BAL samples analyzed for bacterial, fungal, and mycobacterial pathogens. Histopathological biopsies were conducted whererever necessary. The study identified pathogenic organisms in 86.43% of cases, with Pseudomonas aeruginosa (40.71%) and Klebsiella pneumoniae (21.43%) as the predominant pathogens. Notably, malignancies were detected in 13.57% of cases, with squamous cell carcinoma being most common. Bronchoscopy findings indicated mucosal inflammation in 80.71% and endobronchial masses in 12.86% of patients. The results emphasize the diagnostic importance of early bronchoscopy and BAL in non-resolving pneumonia, allowing for tailored treatments and potentially improved patient outcomes. This study supports the integration of bronchoscopy in managing complex pneumonia cases to address diagnostic gaps and treatment challenges, ultimately aiming to reduce mortality in this patient population.