The Role of Bronchoscopy in the Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 2
Abstract
Introduction: Diagnosis of sputum/smear-negative pulmonary tuberculosis patients can be both challenging and time consuming with many patients being put on empirical anti-tubercular treatment. Bronchoscopy may provide a confirmative and early diagnosis in such patients. Aims And Objective: To assess the role of fibreoptic bronchoscopy in patients with suspected pulmonary tuberculosis who have no or inadequate sputum or have a sputum smear negative for acid fast bacillus (AFB) on two samples as per RNTCP 2013 guidelines. Materials And Methods: The study was conducted in department of Pulmonary Medicine, SRMS Institute of Medical Science, Bareilly from 1st Jan 2015 to 31st Dec 2015. Fourty six patients with clinical and radiological evidence of pulmonary TB with no or inadequate sputum or smear negative for AFB on two samples were studied. Fibreoptic bronchoscopy was performed; bronchial washings and bronchial brush was taken. The specimens were subjected to Ziehl Neelsen staining and were examined under oil immersion lens for the presence of AFB. Results: In suspected cases of sputum smear negative pulmonary tuberculosis, the diagnosis of tuberculosis (smear positive) was established in 23 (50%) patients in bronchial brush and 21 (45.7%) patients were positive in bronchial wash, highlighting its role in diagnosis of pulmonary tuberculosis. Patients were followed up after 6 months and those positive for AFB responded well to ATT. Conclusion: Bronchoscopy is a useful tool in diagnosis of pulmonary tuberculosis in sputum smear negative patients. Bronchoscopy reveals a higher bacteriological confirmation of diagnosis in patients with strong clinical and radiological evidence suggestive of pulmonary tuberculosis and those having more risk factors.
Authors and Affiliations
Vikash Gupta
Keywords
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