Culture - bronchoscopic

Alternative names
Bronchoscopic culture

Definition
Bronchoscopic culture is a laboratory test to isolate and identify organisms that cause infection. It is performed on a specimen of lung tissue or secretions from the lung. The specimen is obtained by the procedure of bronchoscopy, in which a tube is passed into the bronchi through the mouth to view the airways of the lungs.

How the test is performed

You are positioned on a table or bed lying on your back. A local anesthetic is sprayed into your throat. When the area is numb, a bronchoscope (a thin, flexible fiberoptic tube) is passed through your nose or mouth and down your throat.

As the tube is inserted, a local anesthetic is put down the tube to anesthetize the deeper tissues. When the bronchoscope is in place, biopsy forceps (a small scissors-like apparatus) may be inserted down the tube to take a biopsy. A bronchial brush may be used to take a sample of cells from the surface, or a suction device may be used to take a sample. The bronchoscope is then removed.

The specimen is sent to the laboratory and placed in culture media. It is examined daily for the presence of microorganisms. If organisms are present, they are classified according to their type. Treatment of infection is based on the results of the culture.

How to prepare for the test
A 1-day stay in the hospital may be necessary, or the procedure may be performed as on outpatient (same-day) basis. Food and fluids are restricted for 6 to 12 hours before the test. You must sign a consent form. Remove dentures or other mouth appliances before the test. You may be given a sedative.

Infants and children:
The preparation you can provide for this test depends on your child’s age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

     
  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
The anesthetic will make your mouth and throat feel thick as it numbs the area. The anesthetic will numb your throat, larynx (voice box), trachea (windpipe), bronchial tubes, and lungs. It will also stop the gagging sensation, but the insertion of the tube may be unpleasant. You may have a sore throat after the procedure.

Why the test is performed
A bronchoscopic culture is performed to detect and identify infection within the lung that cannot be accurately detected by a sputum culture. Evidence of infection such as abscesses, inflammation, or abnormal secretions may be observed during the procedure.

A bronchoscopy may also be performed for respiratory conditions other than infection, such as when cancer is suspected.

Normal Values
No organisms are seen on the culture.

What abnormal results mean
Abnormal culture results usually indicate a respiratory infection. The infection may be caused by bacterial, viral, parasitic, or fungal organisms. The results of the culture will help determine appropriate antimicrobial treatment.

What the risks are
The risks of a bronchoscopic culture are the same as for a bronchoscopy procedure and include bleeding, infection, perforation (hole) of the bronchus or trachea, and pneumothorax. You must refrain from coughing and clearing your throat after the procedure, because it might dislodge a clot at the site of a biopsy.

Special considerations
Not applicable.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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