Diagnostic yield of sputum induction in patients with pleural tuberculosis at a tertiary care hospital in Karachi

2019 ◽  
Vol 23 (11) ◽  
pp. 1213-1216 ◽  
Author(s):  
K. K. Sumalani ◽  
N. Akhter ◽  
D. Chawla ◽  
N. A. Rizvi
Keyword(s):  
Diagnostic Yield ◽  
Tertiary Care ◽  
Lung Parenchyma ◽  
Normal Lung ◽  
Care Hospital ◽  
Sputum Induction ◽  
Pleural Biopsy ◽  
Acid Fast Bacilli ◽  
Pleural Tuberculosis ◽  
Xpert Assay

OBJECTIVE: To evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, culture for Mycobacterium tuberculosis and Xpert® MTB/RIF assay in induced sputum (IS) specimens in patients with pleural tuberculosis (TB).DESIGN: A total of 156 patients were evaluated at Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from April 2016 to December 2017. Patients with exudative lymphocytic pleural effusions with normal lung parenchyma on chest radiography were included in the study: 102 were due to tuberculous and 54 due to non-tuberculous infections as diagnosed using thoracoscopic pleural biopsy. IS samples were sent for acid-fast bacilli (AFB) smear, AFB culture and Xpert assay.RESULT: In patients with a clinical diagnosis of TB, mycobacteria were detected in IS AFB smear in 7.8%, AFB culture in 21.6% and Xpert assay in 34.3% of cases. All sputum samples collected from patients with non-tuberculous aetiology were negative.CONCLUSION: Testing IS samples for M. tuberculosis provides another approach to diagnosing pleural TB, especially in settings in which invasive procedures are less accessible. Our study also emphasises the contagiousness of pleural TB, and the need to screen the household contacts of these patients and possible isolation of patients with pleural TB admitted to hospital.

scholarly journals DIAGNOSTIC YIELD OF ABRAMS PLEURAL BIOPSY IN PATIENTS PRESENTING WITH LYMPHOCYTIC EXUDATIVE PLEURAL EFFUSION.

2019 ◽  
Vol 26 (07) ◽  
pp. 1014-1019
Author(s):  
Kashif Sardar ◽  
Nasir Javed ◽  
Sufyan Saleem Safdar
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Definitive Diagnosis ◽  
Care Hospital ◽  
Pleural Biopsy ◽  
Cross Sectional ◽  
Medical Thoracoscopy ◽  
Exudative Pleural Effusion

Background: Pleural effusion is the one of the most common clinical conditions encountered in pulmonology clinics and the routinely performed tests on pleural fluid do not provide definitive diagnosis in majority of the cases. Medical thoracoscopy with pleural biopsy under direct vision of the abnormal area provides the highest diagnostic yield. Abrams closed needle pleural biopsy is a conventional and cheaper procedure which can help in the definitive diagosis in cases of undiagnosed pleural effusion. Objectives: To determine the diagnostic yield of abrams pleural biopsy in patients presenting with lymphocytic exudative pleural effusion. Study Design: Cross Sectional Study. Setting: Department of Pulmonology Nishtar Hospital Multan; Tertiary care hospital of 1180 beds. Period: Six months. Results: There were 145 patients diagnosed with lymphocytic exudative pleural effusion. Of these 145 study cases, males were 83/145 (57.2%) whereas females were 62/145 (42.8%). Mean age of our patients was 41.62 ± 13.63 years while mean duration of illness was 7.0 ± 3.24 weeks. When the frequencies of various diagnosis established on the basis of histopathology results obtained from the tissue specimen obtained with Abrams pleural biopsy was noted, Tuberculosis was the major cause of lymphocytic exudative pleural effusion as its frequency was noted to be in 81/145 (55.9%) of our patients while malignancy was present in 26/145 (17.9%) of our study cases whereas the histopathology turned out to be inconclusive in 38/145 (26.2%) showing non-specific inflammation. The diagnostic yield of Abrams pleural biopsy turned out to be 73.8% whereas it was unable to establish diagnosis in 26.2%. Conclusion: Abrams needle pleural biopsy is simple, reliable and safe method of diagnosis with a good diagnostic yield. Routine use of this procedure in patients with lymphocytic exudative pleural effusion can lead to a definitive diagnosis in majority of patients.

scholarly journals Comparison between the diagnostic accuracy of Xpert MTB/Rif assay and culture for pleural tuberculosis using tissue biopsy

2019 ◽  
Vol 5 (3) ◽  
pp. 00065-2019
Author(s):  
Nousheen Akhter ◽  
Kamran Khan Sumalani ◽  
Dimple Chawla ◽  
Nadeem Ahmed Rizvi
Keyword(s):  
Diagnostic Accuracy ◽  
Granulomatous Inflammation ◽  
Final Analysis ◽  
Lung Parenchyma ◽  
Normal Lung ◽  
Potential Game ◽  
Pleural Biopsy ◽  
Antituberculous Treatment ◽  
Pleural Tuberculosis ◽  
The Cost

BackgroundEarly diagnosis of pleural tuberculosis is difficult as it is a paucibacillary disease and a combination of tests is required to diagnose it, which have varied diagnostic accuracy and increase the cost. The aim of this study was to evaluate the diagnostic performance of the Xpert MTB/Rif assay on thoracoscopic pleural biopsy specimens.MethodsA total of 201 patients with exudative pleural effusion and normal lung parenchyma were included in the study. All patients underwent thoracoscopic pleural biopsy under local anaesthesia. Biopsy samples were sent for Xpert MTB/Rif assay and culture, along with histopathology. Chronic granulomatous inflammation on histopathology and response to antituberculous treatment was taken as the reference standard for diagnosis of tuberculous pleurisy.ResultsOf the 198 patients included in the final analysis, 134 had pleural tuberculosis. The sensitivity of the Xpert assay was 52.2% and specificity was 100%, and that of pleural biopsy cultures were 41% and 100% respectively.ConclusionThe sensitivity and specificity of Xpert MTB/Rif assay scores were high, hence escalating the speed of diagnosis and imparting marked impact on patient outcomes. The Xpert MTB/Rif assay is a potential game changer in diagnosing pleural tuberculosis.

Diagnostic yield of Archer FusionPlex PanHeme and solid panels: two-year experience from a pediatric tertiary care hospital

2021 ◽  
Vol 132 ◽  
pp. S39-S40
Author(s):  
Kathleen Schieffer ◽  
Eileen Stonerock ◽  
Vijayakumar Jayaraman ◽  
Heather Jenkins ◽  
Tim Peterson ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Care Hospital

“TO STUDY THE CLINICAL PROFILE AND UTILITY OF FIBER-OPTIC BRONCHOSCOPY IN SUSPECTED CASES OF NON RESOLVING PNEUMONIA IN IDENTIFYING ITS ETIOLOGY AT TERTIARY HEALTH CARE CENTRE”

2021 ◽  
pp. 20-22
Author(s):  
Jaypal Singh Chahar ◽  
Naik Pankti S ◽  
Daxini Arvind B ◽  
Agrawal Bhavika
Keyword(s):  
Diagnostic Yield ◽  
Past History ◽  
Tertiary Care ◽  
Fiberoptic Bronchoscopy ◽  
Care Hospital ◽  
Comorbid Conditions ◽  
Health Care Centre ◽  
Great Utility ◽  
Disease Condition ◽  
Diagnostic Modalities

Introduction- Non-resolving pneumonia is always a challenging clinical scenerio where Various diagnostic modalities are greatly required to reach the diagnosis. We aimed to study The role of beroptic bronchoscopy in non-resolving pneumonia along with the various comorbidities associated with the disease condition. Methodology- A prospective observative study in a tertiary care hospital was undertaken. A total of 40 patients diagnosed with non-resolving pneumonia were recruited for diagnostic beroptic bronchoscopy. Results- The overall diagnostic yield of beroptic bronchoscopy in non-resolving pneumonia was 87.5%. The causes of non-resolving pneumonia were Tuberculosis(22.5%), bacterial pneumonia(45%), malignancy(15%), fungal pneumonia(5%). 12.5% patients were undiagnosed. Patients had a signicant past history which also revealed associated comorbid conditions. Diabetes(14(33%)) and COPD(11(27.5%)) were leading comorbid conditions. Conclusion- Fiberoptic Bronchoscopy is a great utility tool in reaching the diagnosis in patients with non-resolving pneumonia.

scholarly journals Evaluation of smear microscopy and geneXpert for the rapid diagnosis of pulmonary and extrapulmonary tuberculosis in a tertiary care hospital in North India: a descriptive prospective study

2018 ◽  
Vol 6 (5) ◽  
pp. 1756
Author(s):  
Danish Zahoor ◽  
Anjum Farhana ◽  
Farhath Kanth ◽  
Munazah Bha
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Rapid Diagnosis ◽  
North India ◽  
Smear Microscopy ◽  
High Morbidity ◽  
Care Hospital ◽  
Cross Sectional ◽  
Xpert Assay

Background: Tuberculosis is a global health problem associated with high morbidity and mortality. Rapid diagnosis of tuberculosis is essential for early disease management. Conventional methods like microscopy and culture are associated with low sensitivity and longer time to positivity respectively. The GeneXpert is an integrated device for the rapid detection of Mycobacterium tuberculosis and its sensitivity to rifampicin. We evaluated the performance of gene expert MTB/ RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis.Methods: A prospective cross sectional study was carried out in the Department of Microbiology. Samples were subjected to smear microscopy by ZN staining, culture on solid (LJ) and liquid media (BacT Alert) and GeneXpert assay.Results: 122 pulmonary samples and 153 extrapulmonary samples collected from 275 patients were included in the study. Out of these, 48 samples were positive by both culture and Xpert assay and 2 samples were culture positive only. Out of 225 culture negative samples, 3 were positive by GeneXpert. The sensitivity for GeneXpert was much higher compared to smear micrscopy (96 Vs 46% respectively). The Xpert assay also detected 3 rifampcin resistant cases.Conclusions: The test appeared to be as sensitive as culture for the detection of tuberculosis in smear positive, smear negative and extrapulmonary tuberculosis. We recommend the use of GeneXpert assay for the early detection of tuberculosis. We conclude that the test is simple and routine staff can perform the test with minimal training.

scholarly journals Comparison between ziehl-neelsen staining and fluorescent staining of sputum samples to detect acid fast bacilli in suspected case of pulmonary tuberculosis at tertiary care hospital, Amreli, Gujarat

2021 ◽  
Vol 8 (4) ◽  
pp. 302-307
Author(s):  
Hetvi Chawda ◽  
Chandani Surani ◽  
Sanjeev Kumar ◽  
Meghana Chauhan ◽  
Ashok Kumar Ramanuj ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Early Morning ◽  
Causative Organism ◽  
Sputum Smear ◽  
Suspected Case ◽  
Care Hospital ◽  
Fluorescent Staining ◽  
Acid Fast Bacilli ◽  
Fluorescent Stain

In India, Tuberculosis (TB) is one of the major community health problems.Pulmonary tuberculosis (PTB) is a respiratory disease. Causative organism for this is acid fast bacilli known as . It is the most ordinary disease affecting the lower socio-economic class in developing countries. Microbiological diagnosis is the heart for the effective treatment of pulmonary TB (PTB). The look forrapid and efficient method has resulted in several staining techniques. Objective of the study was to compare the results of ZN stain (RNTCP) with fluorescent stain by use of microscopy. The study was carried out in Microbiology Department, SMCGH, Amreli. 350 sputum samples (Spot and early morning sample) collected from 175 suspected case of the pulmonary tuberculosis. All 350 samples were processed by ZN stain and Fluorescent stain to detect acid fast bacilli. By use of microscope, the results of the stained smears were given according to RNTCP guideline.Out of 350 sputum smears, 52 (14.85%) and 61 (17.4%) were positive by ZN and FM staining respectively. Males are predominantly affected than females. Majority of the patients were in age above 50 years. Early morning samples were more reliable than spot samples for detection of acid fast bacilli for ZN stain, but not for fluorescent stain.Fluorescent staining with LED microscopy was more efficient than ZN staining for detection of acid fast bacilli from sputum smear.

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