Table 2. Reported infections in BAL of critically and
non-critically ill patients, with positive or negative SARS-Cov-2 BAL
findings.
Abbreviations: Methicillin-resistant S. aureus (MRSA)
Figure 1. Simplified diagnostic algorithm for the use of BAL in
suspected COVID-19. BAL, bronchoalveolar lavage; NP nasopharyngeal.
Figure 2. Paradigmatic clinical case showing COVID-19 and Aspergillus
coinfection in BAL with concomitant lung metastasis from cutaneous
melanoma detected by transbronchial biopsy. 84 years old gentlemen, with
metastatic melanoma, vaccinated for SARS-CoV-2 that developed low grade
fever, cough and dyspnea. A) The HRCT shows mild diffuse ground glass,
with bronchiectasis particularly in the middle lobe and lung nodules. B)
The BAL showed a lymphocytosis (52%, with CD4+ 33% and CD8+ 57%). The
microbiology and virology panel on BAL detected SARS-CoV-2 positivity
with Aspergillus coinfection. Radial-EBUS guided transbronchial biopsies
also documented melanoma lung metastasis.