A study on rapid confirmation of pulmonary tuberculosis in smear-negative acid fast bacilli cases by using fiberoptic bronchoscopy, done through a trans oro pharyngeal spacer

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.

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ROLE OF FIBEROPTIC BRONCHOSCOPY IN PATIENTS WITH SPUTUM SMEAR NEGATIVE FOR ACID FAST BACILLI AND CHEST X - RAY SUGGESTIVE OF PULMONARY TUBERCULOSIS

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2015/20 ◽

2015 ◽

Vol 2 (2) ◽

pp. 155-164

Author(s):

Rajesh Kumar Jain S ◽

Arun B J ◽

Paramjyothi G K

Keyword(s):

Pulmonary Tuberculosis ◽

Fiberoptic Bronchoscopy ◽

Sputum Smear ◽

X Ray ◽

Acid Fast Bacilli ◽

Chest X Ray ◽

Smear Negative

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Diagnostic role of fiberoptic bronchoscopy in suspected smear negative pulmonary tuberculosis

Respiratory Medicine ◽

10.1016/0954-6111(95)90231-7 ◽

1995 ◽

Vol 89 (9) ◽

pp. 621-623 ◽

Cited By ~ 35

Author(s):

S. Charoenratanakul ◽

W. Dejsomritrutai ◽

A. Chaiprasert

Keyword(s):

Pulmonary Tuberculosis ◽

Fiberoptic Bronchoscopy ◽

Diagnostic Role ◽

Smear Negative

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Role of flexible fiberoptic bronchoscopy in suspected sputum smear negative pulmonary tuberculosis cases at microscopy centre under RNTCP

International Journal of Medical Science and Public Health ◽

10.5455/ijmsph.2013.200920133 ◽

2014 ◽

Vol 3 (1) ◽

pp. 31 ◽

Cited By ~ 1

Author(s):

Adesh Kumar ◽

Ashish Gupta ◽

Mohd Khan

Keyword(s):

Pulmonary Tuberculosis ◽

Fiberoptic Bronchoscopy ◽

Sputum Smear ◽

Flexible Fiberoptic Bronchoscopy ◽

Smear Negative

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Validation of a model for predicting smear-positive active pulmonary tuberculosis in patients with initial acid-fast bacilli smear-negative sputum

European Radiology ◽

10.1007/s00330-017-4959-9 ◽

2017 ◽

Vol 28 (1) ◽

pp. 243-256 ◽

Cited By ~ 8

Author(s):

Jun -Jun Yeh

Keyword(s):

Pulmonary Tuberculosis ◽

Active Pulmonary Tuberculosis ◽

Acid Fast Bacilli ◽

Smear Negative ◽

Negative Sputum

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

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v8i1.29828 ◽

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.

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DIAGNOSTIC ROLE OF ENDOBRONCHIAL WASHINGS AND BIOPSY IN SMEAR NEGATIVE PULMONARY TUBERCULOSIS AND ITS CORRELATION WITH HIGH RESOLUTION COMPUTED TOMOGRAPHY CHEST FINDINGS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i4.5413 ◽

2021 ◽

Vol 71 (4) ◽

pp. 1341-45

Author(s):

Maryam Hussain ◽

Sultan Mehmood Kamran ◽

Rizwan Azam ◽

Asifullah Khan ◽

Sohaib Ahmed ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Pulmonary Tuberculosis ◽

Diagnostic Yield ◽

Military Hospital ◽

High Resolution Computed Tomography ◽

Cross Sectional ◽

Acid Fast Bacilli ◽

Smear Negative

Objective: To determine role of endobronchial washings/biopsy in diagnosis of smear negative pulmonary tuberculosis and evaluate their association with computed tomography findings. Study Design: Cross-sectional - analytical study. Place and Duration of Study: Department of Pulmonology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2020. Methodology: Patients having symptoms of pulmonary tuberculosis and abnormal findings on chest imaging with negative sputum smears for acid fast bacilli were selected for endobronchial washings. Bronchoscopy for washings was carried out in these patients and sample was sent for Acid fast bacilli stain, Mycobacterium tuberculosis gene Xpert and acid fast bacilli culture and sensitivity bacterial culture and fungal hyphae. In case of mass lung endobronchial and/or transbronchial lung biopsy was done and sample was sent for histopathology Active pulmonary tuberculosis was labelled as per definition. Results: Out of 105, 75 (71.4%) were male and 30 (28.6%) were female. Mean age was 55.69 ± 17.33 years. Total 40 (38.09%) were diagnosed with pulmonary tuberculosis (based on smear, genexpert, culture and histopathology). In these 40 patients, computed tomographic findings showed consolidation in 10 (25%) cases, cavity in 7 (17.5%), bronchiectasis in 3 (7.5%), mass in 1 (2.5%), pleural effusion in 2 (5%), lymphadenopathy in 1 (2.5%) and tree-in-budappearance in 12 (30%) cases. Conclusion: High resolution computed tomography and endobronchial washing both combined together increase the diagnostic yield in smear negative cases.

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Incremental yield of bronchial washing for diagnosing smear-negative pulmonary tuberculosis

Revista de Saúde Pública ◽

10.1590/s0034-8910.2013047004548 ◽

2013 ◽

Vol 47 (4) ◽

pp. 813-816 ◽

Cited By ~ 2

Author(s):

Alonso Soto ◽

Vilma Acurio ◽

Lely Solari ◽

Patrick Van der Stuyft

Keyword(s):

Pulmonary Tuberculosis ◽

Diagnostic Yield ◽

Sputum Culture ◽

Acid Fast Bacilli ◽

Bronchial Washing ◽

Tuberculosis Diagnosis ◽

Smear Negative ◽

Work Up

OBJECTIVE To assess the increased diagnostic yield for pulmonary tuberculosis using bronchial washing cultures compared with sputum cultures. METHODS Study conducted with 61 adults in Lima, Peru, from January 2006 to December 2007. The yield of sputum cultures was compared with the yield of acid-fast bacilli smears and cultures of bronchial washing for diagnosing pulmonary tuberculosis in suspected cases of clinical tuberculosis with negative acid fast bacilli sputum smears. RESULTS Twenty seven (95%CI 32;58) of the cases were eventually diagnosed with smear-negative pulmonary tuberculosis. Bronchial washing samples detected 23 (95%CI 72;99) of the smear-negative pulmonary tuberculosis cases compared with 15 (95%CI 37;74) for sputum cultures (p = 0.02). The incremental diagnostic yield of acid fast bacilli smear and culture of bronchial washing specimens over sputum culture was 44% (95%CI 25;65). CONCLUSIONS In function of the epidemiological context and the resources available, bronchoscopy should be deployed as part of a comprehensive work up that optimizes smear-negative pulmonary tuberculosis diagnosis and minimizes risk and costs.

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