Prospective analysis of clinical characteristics and risk factors of postbronchoscopy fever

Study objectives: To assess the clinical characteristics of fever after fiberoptic bronchoscopy (FOB) and to identify the independent risk factors of postbronchoscopy fever. Study design: Prospective study. Setting: Tertiary care university hospital. Study subjects: Immunocompetent adults undergoing FOB between July 2001 and April 2002. Measurements and results: Five hundred eighteen adults were included in this study. The incidence of postbronchoscopy fever was 5%, and the mean onset time of the fever was 8.7 ± 1.1 h after FOB (mean ± SEM). In most cases, the fever subsided spontaneously within a day, with a mean fever duration of 14.0 ± 3.1 h. No organisms were isolated from blood culture specimens drawn at the time of fever, although significant increases in total leukocytes and neutrophil counts were observed in the peripheral blood at the time of fever compared to levels prior to FOB. Univariate analysis showed that fever was related to multiple factors, such as the radiologic extent of involvement, consolidation, abnormal bronchoscopic findings, biopsy, lavage, the amount of saline solution or drug administered, the duration of the procedure, the severity of bleeding, and a final diagnosis of pulmonary tuberculosis. However, after multivariate analysis, the final diagnosis of pulmonary tuberculosis and the severity of bleeding were identified as independent risk factors. Conclusions: Fever after FOB occurs relatively frequently but transiently in immunocompetent adults. Independent risk factors for the development of this complication seem to be related to the diagnosis of pulmonary tuberculosis and the severity of bleeding during FOB.