Role of fibreoptic bronchoscopy in sputum smear negative pulmonary tuberculosis

1994 ◽  
Vol 75 ◽  
pp. 29
Author(s):  
A. McDaniel ◽  
N. Schoenfeld ◽  
W. Frank ◽  
A. Grassot ◽  
H. Mauch ◽  
...  
Author(s):  
Atul Luhadia ◽  
Shanti K. Luhadia ◽  
Shubham Jain ◽  
Mohammad Hamza Hanfe ◽  
Divax Oza ◽  
...  

Background: Sputum smear negative pulmonary tuberculosis is a common problem faced by clinicians. Fiberoptic bronchoscopy may be very useful in diagnosing these cases which have no sputum or whose sputum smear is negative for acid fast bacilli. Objective of the current study was to assess the role of fiberoptic bronchoscopy in sputum smear negative under NTEP and radiologically suspected cases of pulmonary tuberculosis.Methods: Clinico-radiological suspected cases of pulmonary tuberculosis patients in whom two sputum smear for acid fast bacilli by Ziehl Neelsen stain under NTEP was negative were included in the study. Fiberoptic bronchoscopy was performed in all these patients and samples taken were sent for investigations.Results: Fiberoptic bronchoscopy was performed in 250 patients of suspected pulmonary tuberculosis whose sputum for AFB smear was negative. Cough was the most predominant symptom. Radiologically, right side disease was more common and upper zone was most commonly involved and infiltrates were common radiological finding. During bronchoscopy, congestion and hyperaemia (36%) and mucopurulent/mucoid secretions (32%) was seen in maximum number of cases. BAL was positive in 200 patients (80%), post bronchoscopy sputum was positive in 70 cases (28%) and biopsy was positive in 12 patients out of 16 performed biopsies (75%). The total TB positive cases after combining all the methods were 215 making the overall diagnostic yield of 86%.Conclusions: Fiberoptic bronchoscopy and post bronchoscopy sputum can be very useful for diagnosing sputum for AFB smear negative but clinico-radiological suspected cases of pulmonary tuberculosis patients.


2020 ◽  
Vol 8 (1) ◽  
pp. 19-22
Author(s):  
Subodh Sagar Dhakal ◽  
Ashmita Neupane ◽  
Shatdal Chaudhary ◽  
Navin Mishra ◽  
Damber Bdr Karki

INTRODUCTION: Sputum smear examination for acid fast bacilli (AFB) by Ziehl-Neelsen stain (ZN stain) is the initial approach to the diagnosis of pulmonary tuberculosis (PTB). But 50% of the cases are reported to be sputum smear negative. This study was aimed to investigate the diagnostic yield of fibreoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis. The sample was tested for Mycobacterium tuberculosis using the XpertMTB/RIF assay, which is a new test that detects Mycobacterium tuberculosis complex and resistance to rifampin in less than two hours. MATERIAL AND METHODS: This is a prospective cross sectional study carried out on 58 sputum smear negative patients who were clinically suspected to have pulmonary tuberculosis from April 2017 to January 2019. All patients are subjected to FOB, BAL and BAL specimens were stained for AFB and also sent for Xpert (MTB)/RIF. RESULTS: Among 58 patients enrolled for the study 26 patients were positive for acid fast bacilli (AFB) through BAL stain and Xpert (MTB)/RIF combined. CONCLUSION: FOB guided BAL is a reliable, alternative and rapid method for diagnosing smear negative pulmonary tuberculosis with minimal complications.


Author(s):  
Mayank Kapur ◽  
Atul Luhadia ◽  
Shanti Kumar Luhadia

Background: Pulmonary Tuberculosis is one of the common infections in the world, especially in developing countries like India and is a leading cause of morbidity and mortality worldwide. Therefore, early diagnosis and microbiological confirmation of pulmonary TB is important. This study was done to assess the role of induced sputum with hypertonic saline in suspected pulmonary TB patients who produce no or inadequate sputum or who are sputum for AFB smear negative.Methods: 100 patients with clinical and radiological evidence of pulmonary TB with no or inadequate sputum or who are smear negative with spontaneous sputum were included in the study. Sputum was induced with 5ml of 3% hypertonic saline delivered through nebulizer and then was sent for Ziehl Neelsen staining examination.Results: 96 patients could produce adequate sputum after sputum induction. In 47 patients, sputum for AFB smear was found positive after induction.Conclusions: Sputum induction is a safe, cheap and non-invasive procedure and offers an alternative or additional approach in the diagnosis of sputum smear-negative suspected pulmonary tuberculosis patients and would enhance sensitivity for the diagnosis of tuberculosis. 


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