Jahn K et al. conducted a prospective single-center observational study and found that treatment management changed in approximately half of the patients with immunocompromised lower respiratory tract infections undergoing bronchoalveolar lavage (BAL) examination [1]. Differential diagnosis of pulmonary lesions in immunocompromised patients is more diverse compared to immunocompetent patients [2], and while there are frequent situations where BAL examination is preferable, there is also a dilemma in clinical practice where BAL examination cannot actually be performed due to its invasiveness.