scholarly journals Endobronchial tuberculosis: histopathological subsets and microbiological results

2012 ◽  
Vol 7 ◽  
Author(s):  
Sevket Ozkaya ◽  
Salih Bilgin ◽  
Serhat Findik ◽  
Hayriye Çete Kök ◽  
Canan Yuksel ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Lavage Fluid ◽  
Tracheobronchial Tree ◽  
Sputum Smear ◽  
Tuberculous Infection ◽  
Bronchial Lavage ◽  
Culture Positivity ◽  
Endobronchial Tuberculosis ◽  
Smear Negative ◽  
Histopathological Evidence

Background: Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. Bronchoscopic appearances of EBTB have been divided into seven subtypes: actively caseating, edematous-hyperemic, fibrostenotic, tumorous, granular, ulcerative, and nonspecific bronchitic. However, information for establishing a definite microbiological diagnosis in each of these categories is lacking. We aimed to present bronchoscopic appearances and percentages for the EBTB subtypes and to compare bronchoscopic appearances with microbiological positivity in bronchial lavage fluid. Methods: From 2003 to 2009, 23 biopsy-proven EBTB patients were enrolled in the study. Diagnosis of EBTB was histopathologically confirmed in all patients. Results: The commonest subtype was the edematous-hyperemic type (34.7%); other subtypes in order of occurrence were: tumorous (21.7%), granular (17.3%), actively caseating (17.3%), fibrostenotic (4.3%), and nonspecific bronchitic (4.3%). Although all patients were sputum-smear-negative for acid-fast bacilli (AFB), 26% of patients were smear-positive for AFB in the bronchial lavage fluid. The bronchial lavage fluid grew Mycobacterium tuberculosis in 39.1% of all patients. The bronchial lavage smear positivity for AFB in the bronchial lavage fluid was 75%, 25%, 20%, 12.5%, 0%, and 0% for the granular, actively caseating, tumorous, edematous-hyperemic, fibrostenotic, and nonspecific bronchitic subtypes of EBTB, respectively. Culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid was 75%, 50%, 40%, 25%, 0%, and 0%, respectively. Conclusion: The commonest subtype of EBTB was the edematous-hyperemic subtype. The granular type had the highest smear positivity and culture positivity for Mycobacterium tuberculosis in bronchial lavage fluid. Bronchoscopy should be performed in all patients suspected to have EBTB.

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 Diagnostic Utility of Bronchial Washing CBNAAT for Mycobacterium Tuberculosis in Sputum Smear Negative and Sputum CBNAAT Negative Patients of Suspected Pulmonary Tuberculosis

2021 ◽  
Vol 6 (03) ◽  
pp. 201-204
Author(s):  
Afshan Ali Shaik ◽  
Uday Kakodkar ◽  
Cigy Borges
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Fluorescent Microscopy ◽  
Case Series ◽  
Tuberculosis Treatment ◽  
Sputum Smear ◽  
Diagnostic Utility ◽  
Fungal Culture ◽  
Bronchial Washing ◽  
Smear Negative

Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time consuming, with many patients being put on empirical anti-tuberculosis treatment. Bronchoscopy helps in early diagnosis in such patients. Aims and Objectives: To assess the diagnostic utility of bronchial washing CBNAAT for Mycobacterium Tuberculosis in sputum smear negative and sputum CBNAAT negative patients of suspected pulmonary tuberculosis. Methodology: This case series was conducted on 71 patients in the Department of Pulmonary Medicine, Goa Medical College from May 2018- February 2020. Patients with suspected pulmonary tuberculosis on chest radiograph and/or CT thorax, but with sputum smear as well as CBNAAT for Mycobacterium Tuberculosis negative were subjected to flexible video bronchoscopy. Bronchial washings were collected from the affected lobes and the specimen were subjected to fluorescent microscopy, CBNAAT, MGIT, bacterial and fungal culture. Results: The diagnosis of tuberculosis was established in 23 (32.4%) patients in bronchial washings specimen by CBNAAT. These patients were followed up after 6 months of anti-tuberculosis treatment and have shown significant clinical and radiological improvement. Conclusion: Bronchoscopy is a useful tool in diagnosis of pulmonary tuberculosis in sputum negative patients. It also play an important role in diagnosis of other infectious /malignant disorder which can mimic tuberculosis.

Real-time PCR in Bronchoalveolar Lavage Fluid in the Sputum Smear-Negative Patients Suspected of Pulmonary Tuberculosis by Chest CT

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 673A
Author(s):  
Yee Hyung Kim ◽  
Sohee Park ◽  
Cheon Woong Choi ◽  
Jee-Hong Yoo ◽  
Hong Mo Kang ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Real Time ◽  
Real Time Pcr ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Chest Ct ◽  
Sputum Smear ◽  
Smear Negative

scholarly journals Detection of Mycobacterium tuberculosis in AFB smear-negative sputum specimens through MTB culture and GeneXpert® MTB/RIF assay

2019 ◽  
Vol 33 ◽  
pp. 205873841982717 ◽  
Author(s):  
Ghulam Rasool ◽  
Arif Muhammad Khan ◽  
Raza Mohy-Ud-Din ◽  
Muhammad Riaz
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Diagnostic Methods ◽  
Public Health Issue ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Study Population ◽  
Smear Negative ◽  
Negative Sputum

Tuberculosis (TB) is an important public health issue around the globe which is a chronic infectious disease and is still one of the major challenges for developing countries. The emergence of drug-resistant TB makes the condition worse and there is an urgent need of fast, highly sensitive diagnostic methods. This study was undertaken to evaluate the performance of GeneXpert® MTB/RIF assay and MTB culture for the detection of Mycobacterium tuberculosis (MTB) in sputum smear-negative pulmonary TB/drug-resistant tuberculosis (DR-TB) suspects. A total of 168 sputum smear-negative TB suspects were recruited for the study. Among the suspected TB cases, 52.98% were male and 47.02% were females with the mean age of 42 ± 17.6 years. All the sputum specimens collected from the study population were subjected to Ziehl–Neelsen (ZN) smear microscopy, GeneXpert MTB/RIF assay, and MTB culture. The results revealed that, out of 168 acid-fast bacilli (AFB)/ZN smear microscopy–negative sputum specimens, 48 (28.57%) and 58 (34.52%) were detected MTB positive by GeneXpert MTB/RIF assay and MTB culture, respectively, while 120 (71.43%) and 110 (65.48%) suspected TB cases were confirmed negative by GeneXpert MTB/RIF assay and MTB culture, respectively. The study concluded that GeneXpert assay was found to be a rapid and accurate tool for MTB detection in smear-negative sputum specimens. GeneXpert has advantage over ZN smear microscopy and MTB culture as it detects MTB and rifampicin resistance simultaneously within 2 h with minimal biohazards.

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