scholarly journals Diagnostic Value of Bronchoalveolar Lavage Examination in Sputum Negative Patients for AFB in Suspected Pulmonary Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 84-87
Author(s):  
Safayet Ahammed ◽  
Mohammed Sana Ullah Sarker ◽  
Md Zulfikar Ali
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Diagnostic Testing ◽  
Diagnostic Value ◽  
Fibreoptic Bronchoscopy ◽  
Diagnostic Challenge ◽  
Cross Sectional ◽  
Lowenstein Jensen ◽  
Smear Negative ◽  
Mycobacterial Growth

Background: Pulmonary tuberculosis (PTB) is one of the most common infections worldwide, more commonly among the developing countries like Bangladesh. So its early detection and prompt treatment was a challenge and the burden of diagnostic challenge was higher if the patients smear negative for Acid Fast Bacilli (AFB). Objective: Evaluate the diagnostic value of Bronchoalveolar lavage (BAL) for diagnosis of suspected Pulmonary Tuberculosis (PTB) whose sputum for AFB smear neagtive. Materials and Methods: A cross-sectional observational reserach was undertaken where 50 patients were included on the basis of specific inclusion and exclusion criteria. All patients who had negative smear for AFB but highly suspected for PTB underwent fibreoptic bronchoscopy to collect Bronchoalveolar lavage (BAL) fluid for diagnostic testing in the form of BAL for AFB and mycobacterial culture in Lowenstein Jensen medium. Results: The Male predominacy 29 (58%) was obserevd among the smear negative PTB patients. Clinically more than seventy percent (72%) presents with fever then cough with sputum and haemoptysis 62% and 32% respectively. Radiological cavitation 33 (66%) was the most common x-ray findings. After analysis of BAL for AFB about 31 (62%) patient found positive and on culture about mycobacterial growth found in 29 (58%) patients. Conclusion: Bronchoalveolar lavage had a superior diagnostic value in patients with smear negative suspected pulmonary tuberculosis. KYAMC Journal.2021;12(02): 84-87

scholarly journals Utility of Bronchoalveolar Lavage in the Diagnosis of Sputum Negative Pulmonary Tuberculosis

2020 ◽  
Vol 8 (1) ◽  
pp. 19-22
Author(s):  
Subodh Sagar Dhakal ◽  
Ashmita Neupane ◽  
Shatdal Chaudhary ◽  
Navin Mishra ◽  
Damber Bdr Karki
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Diagnostic Yield ◽  
Cross Sectional Study ◽  
Fibreoptic Bronchoscopy ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Acid Fast Bacilli ◽  
Smear Negative

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.

scholarly journals The value of GeneXpert MTB/RIF in bronchoalveolar lavage fluid in the diagnosis of smear-negative pulmonary tuberculosis

2021 ◽  
Vol 62 (1) ◽  
pp. 28-36
Author(s):  
Yue-Ying Zhou ◽  
Ji-Chan Shi ◽  
Ning Pan ◽  
Zheng-Xing Wu ◽  
Ai-Qiong Cheng ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Liquid Culture ◽  
Drug Sensitivity ◽  
Bronchoalveolar Lavage Fluid ◽  
Culture Method ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Smear Negative ◽  
Acid Fast Staining

This study aims to evaluate the diagnostic value of Xpert MTB/ RIF assay in bronchoalveolar lavage fluid (BALF) in subjects with smear-negative pulmonary tuberculosis. From January 2019 to December 2019, 197 patients with suspected pulmonary tuberculosis were recruited, and bronchoalveolar lavage fluid was collected for acid-fast staining smear, liquid culture of Mycobacterium combined drug sensitivity and Xpert MTB/RIF detection. The sensitivity, specificity, positive predictive value and negative predictive value of Xpert MTB/RIF in bronchoalveolar lavage fluid (BALF) were calculated with smear-negative pulmonary tuberculosis as the reference standard. The consistency of xpert MTB/RIF in the diagnosis of rifampicin resistance was evaluated, with the results of Mycobacterium liquid culture drug sensitivity test and drug sensitivity test as the gold standards. The results showed that among 197 suspected tuberculosis patients, 55 patients were not diagnosed with tuberculosis and 142 patients were diagnosed with smear-negative pulmonary tuberculosis. One hundred and twenty three cases (86.62%) were positive for Xpert MTB/ RIF in bronchoalveolar lavage fluid, 15 cases (10.56%) were positive by acid-fast staining smear method, and 88 cases (61.97%) were positive by the liquid culture method. The positive rate of Xpert MTB / RIF was 93.18% (82 / 88), which was higher than that of 75.93% (41 / 54) of the negative BALF mycobacterium culture (χ 2 = 8.598, P<0.01). The sensitivity and specificity of Xpert MTB/RIF for rifampicin resistance were 100.00% and 97.30%, respectively. Therefore, the diagnostic value of Xpert MTB/RIF in bronchoalveolar lavage fluid for bacterialnegative pulmonary tuberculosis is superior to the acid-fast staining smear of lavage fluid and the mycobacterium culture method.

scholarly journals Diagnosing sputum smear negative pulmonary tuberculosis patients by transbronchial biopsy and bronchoalveolar lavage smear.

2020 ◽  
Vol 27 (03) ◽  
pp. 499-505
Author(s):  
Mahwish Niaz ◽  
Mumtaz Ahmad ◽  
Kanwal Fatima ◽  
Faiza Kazi ◽  
Hassan Salim ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Accuracy ◽  
Bronchoalveolar Lavage ◽  
Disease Transmission ◽  
Predictive Value ◽  
Transbronchial Biopsy ◽  
Sputum Smear ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Smear Negative

Pulmonary tuberculosis is one of the leading causes of infectious disease related mortality. Transbonchial biopsy and bronchoalveolar lavage smear obtained by bronchoscopy provides greater quantity of material for analysis, thus increases the chances of diagnosing the disease. Objectives: To diagnose sputum smear negative pulmonary tuberculosis patients by Transbronchial Biopsy and Bronchoalveolar smear keeping bronchoalvelar lavage culture as gold standard. To calculate and compare the diagnostic accuracy of transbronchial biopsy and bronchoalveolar lavage smear in sputum negative patients. Study Design: Cross-sectional validation study. Setting: Department of histopathology, Foundation University Medical College, Islamabad and Department of Pulmonology and Microbiology, Fauji Foundation Hospital, Rawalpindi. Period: From May 2016 to May 2017. Materials & Methods: It comprised 96 patients who underwent bronchoscopy. Transbronchial biopsy, bronchoalveolar lavage smear preparation and bronchoalveolar lavage culture was performed on specimens of all patients. Results: Out of 96 patients 22 (22.91%) patients were actually having tuberculosis whereas 74 (77%) had only clinical and radiological suspicion of tuberculosis. The mean age of patients was 43 years with a standard deviation of ±19.1 .The age range was 12-80 years. The sensitivity, specificity, positive predictive value, negative predictive value and true positives of transbronchial biopsy were 68.1%, 77%, 46.8%, 89% and15.62% while the values for bronchoalveolar lavage were 50%, 97.29%, 84.6%, 86.7% and 11.45% respectively. Thus, the diagnostic accuracy calculated for transbronchial biopsy and bronchoalveolar lavage was 75% and 13.54% respectively. Conclusions: Bronchoscopy should be done in all sputum negative tuberculosis patients having strong clinical and radiological suspicion to obtain transbronchial biopsy and bronchoalveolar lavage for timely diagnosis, treatment and prevention of disease transmission as well as to avoid empirical treatment and its side effects in patients having no tuberculosis. The diagnostic accuracy of transbronchial biopsy is almost 5 times more compared to bronchoalveolar lavage smear.

scholarly journals Diagnostic value of nucleic acid amplification tests on bronchoalveolar lavage fluid for smear-negative pulmonary tuberculosis: a meta-analysis

2015 ◽  
Vol 35 (4) ◽  
Author(s):  
Panwen Tian ◽  
Yongchun Shen ◽  
Ye Wang ◽  
Chun Wan ◽  
Mei Feng ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Meta Analysis ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Nucleic Acid Amplification ◽  
Nucleic Acid Amplification Tests ◽  
Smear Negative

Based on current available evidence, NAAT on BALF plays a role in the diagnosis of smear-negative pulmonary tuberculosis, and further studies should be performed to confirm our findings..

scholarly journals Diagnostic value of bronchoalveolar lavage and bronchial washing in sputum-scarce or smear-negative cases with suspected pulmonary tuberculosis: a randomized study

2020 ◽  
Vol 26 (7) ◽  
pp. 911-916 ◽  
Author(s):  
Y.W. Kim ◽  
B.S. Kwon ◽  
S.Y. Lim ◽  
Y.J. Lee ◽  
Y.-J. Cho ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Randomized Study ◽  
Diagnostic Value ◽  
Bronchial Washing ◽  
Smear Negative

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 ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Fibreoptic Bronchoscopy ◽  
Sputum Smear ◽  
Smear Negative

scholarly journals Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037913
Author(s):  
Mala George ◽  
Geert-Jan Dinant ◽  
Efrem Kentiba ◽  
Teklu Teshome ◽  
Abinet Teshome ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Secondary Outcome ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative ◽  
Culture Positive ◽  
Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

scholarly journals S38 Predictive accuracy and clinical impact of Xpert MTB/RIF for the diagnosis of sputum smear-negative pulmonary tuberculosis using bronchoalveolar lavage fluid

Thorax ◽  
2015 ◽  
Vol 70 (Suppl 3) ◽  
pp. A26.1-A26
Author(s):  
W Ho ◽  
DW Connell ◽  
A Singanayagam ◽  
A Singanayagam ◽  
H Donaldson ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Predictive Accuracy ◽  
Lavage Fluid ◽  
Clinical Impact ◽  
Sputum Smear ◽  
Smear Negative

scholarly journals ROLE OF FIBREOPTIC BRONCHOSCOPY IN THE DIAGNOSIS OF SPUTUM SMEAR-NEGATIVE PULMONARY TUBERCULOSIS IN TERTIARY CARE

2016 ◽  
Vol 3 (73) ◽  
pp. 3957-3960
Author(s):  
Muthukumar Shunmugam ◽  
Joseph Pratheeban ◽  
Suresh Kumar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Fibreoptic Bronchoscopy ◽  
Sputum Smear ◽  
Smear Negative
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