1887
Volume 2002, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

To assess the diagnostic value of fiberoptic bronchoscopy (FOB) in patients with abnormal chest radiographs suggestive of pulmonary tuberculosis (PTB) but with negative sputum smears for acid fast bacilli (AFB), a retrospective study was made of all such cases referred to the Pulmonary Diseases Service at Hamad Medical Corporation between July 1997 and June 2000. It included patients unable to produce any sputum sample. From 193 FOB procedures, active pulmonary tuberculosis was diagnosed in 58 patients (30 %). The diagnosis was confirmed either by finding acid fast bacilli in a smear or by culture of bronchial washings or bronchoalveolar lavage (BAL), or by demonstrating caseating granulomata on transbronchial or endobronchial biopsy. In 19 of58 (33%) positive cases, the diagnosis was rapidly established by demonstrating AFB in smears of bronchial aspirate or by positive histopathology. It is concluded that FOB is still the gold-standard procedure in the diagnosis of pulmonary tuberculosis in those patients in whom the diagnosis cannot be established by sputum examination, thus allowing early diagnosis in a significant proportion of them. The results are in agreement with similar studies.

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2002-11-01
2024-11-13
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References

  1. Dye C, Scheele S, Dolin P, Pathania V, Raviglione M. Global Burden of Tuberculosis. Estimated Prevalence, and Mortality by Country. JAMA. 1999; 282::677686.
    [Google Scholar]
  2. Kim TC, Blackman RS, Heatwole KM, Kim T, Rochester DF. Acid-fast bacilli in sputum smears of patients with pulmonary tuberculosis. Am. Rev. Respir. Dis. 1984; 129::264268.
    [Google Scholar]
  3. Taut JF. The role of repeated sputum examination in the diagnosis of pulmonary tuberculosis. South Africa Medical Journal. 1974; 46::16741676.
    [Google Scholar]
  4. Gordin F, Slutkin G. The validity of acid-fast smears in the diagnosis of pulmonary tuberculosis. Arch. Pathol. Lab. Med. 1990; 114::10251027.
    [Google Scholar]
  5. Uddenfeldt M, Lundgren R. Flexible Fiberoptic Bronchoscopy in the diagnosis of pulmonary tuberculosis. Tubercle. 1981; 62::197199.
    [Google Scholar]
  6.   Fiberoptic Bronchoscopy and sputum-negative tuberculosis. Lancet. 1983;:337338.
    [Google Scholar]
  7. Al Kassimi FA, Azhar M, Al Majid S, Al Wazzan AD, Al Hajjaj MS, Malibary T. Diagnostic role of Fiberoptic Bronchoscopy in tuberculosis in the presence of typical X-ray pictures and adequate sputum. Tubercle. 1991; 72::145148.
    [Google Scholar]
  8. Chan HS, Sun AJM, Hoheisel GB. Bronchoscopic aspiration and Bronchoalveolar lavage in the diagnosis of sputum smear-negative pulmonary tuberculosis. Lung. 1990; 168::215220.
    [Google Scholar]
  9. Ip M, Chau PY, So SY, Lan WK. The value of routine bronchial aspirate culture at Fiberoptic Bronchoscopy for the diagnosis of tuberculosis. Tubercle. 1989; 70::281285.
    [Google Scholar]
  10. De Gracia J, Curull V, Vidal R, Riba A, Orriols R, Martin N, Morell F. Diagnostic value of bronchoalveolar lavage in suspected pulmonary tuberculosis. Chest. 1988; 93::329332.
    [Google Scholar]
  11. Al Zahrani K, Al Jahdali H, Poirier L, Rene P, Menzies D. Yield of smear, culture and amplification tests from repeated sputum induction for the diagnosis of pulmonary tuberculosis. Int J Tuberc Lung Disease. 2001; 5:9:855860.
    [Google Scholar]
  12. Anderson C, Inhaber N, Menzies D. Comparison of sputum induction with Fiberoptic Bronchoscopy in the Diagnosis of Tuberculosis. Am J Respir Crit Care Med. 1995; 152::15701574.
    [Google Scholar]
  13. Conde MB, Soares SLM, Mello FCQ, Rezende VM, Daley LL, Kritski AL. Comparison of sputum induction with Fiberoptic Bronchoscopy in the Diagnosis of Tuberculosis. Am J Respir Crit Care Med. 2000; 162::22382240.
    [Google Scholar]
  14. Tevola K. Bronchial aspiration in the Diagnosis of Pulmonary Tuberculosis. Scand J Respir Dis ;suppl. 1974; 89::151154.
    [Google Scholar]
  15. Woodring JH, Vandiviere HM, Fried AM, Dillon ML, Williams TD, Melvin IG. Update; The radiographic features of Pulmonary Tuberculosis. AJR. 1986; 146::497506.
    [Google Scholar]
  16.   Hong Kong chest service/Tuberculosis Research Center Madras/British Medical Research Council. Sputum Smearnegative Tuberculosis. Lancet. 1979; 1::13611363.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): Fiberoptic Bronchoscopy and Tuberculosis
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