Strongyloides stercoralis and Hyperinfection
Q: Chronic infection with which parasite is a known risk factor for strongyloidiasis hyperinfection?
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The presence of alveolar macrophages is the most reliable indicator of specimen adequacy in bronchoalveolar lavage (BAL), confirming that the sample originates from the alveolar spaces rather than just the airways. Adequate BAL typically contains >80% alveolar macrophages in the cellular differential. Other adequacy criteria include: total cell count >100,000 cells/mL, minimal squamous epithelial contamination (indicating oropharyngeal contamination), and good cellular preservation. BAL without alveolar macrophages may represent bronchial washings or contaminated specimens, limiting interpretation for alveolar diseases like interstitial lung diseases or Pneumocystis pneumonia.
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