TY - JOUR T1 - Bronchoscopic evaluation of childhood pulmonary tuberculosis: Risk factors of airway involvement and contribution of BAL in the bacteriological diagnosis JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 5015 AU - Erkan Cakir AU - Arif Kut AU - Emin Ozkaya AU - Ahmet Hakan Gedik AU - Levent Midyat AU - Mustafa Nursoy Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/5015.abstract N2 - Background: Airway involvement (AI) is common in childhood pulmonary tuberculosis (TB). We aimed to describe the risk factors of AI and to investigate the contribution of bronchoalveolar lavage (BAL) in the bacteriological diagnosis. Methods: The study was held in two pediatric pulmonology centers in Istanbul, Turkey. Among 492 children with pulmonary TB followed between 2008 and 2012, 167 (29 %) patients who had flexible bronchoscopy (FB) were enrolled to the study. Risk factors associated with AI were analyzed and microbiologic results of the BAL and gastric aspirates (GA) were compared. Results: AI was found in 55% of the patients. AI was diagnosed significantly more common in patients with resistance to TB therapy than the patients having FB performed at initial presentation (p=0.002, OR: 2.682, CI: 1.43-5.02). AI was found more frequently in the younger children, patients with primary TB, and having lymphadenopathy with parenchymal involvement without statistical significance. There was no significant difference with respect to gender, tuberculin skin test positivity, and history of contact with TB. Mycobaterium tuberculosis was isolated in 54 (32.6%) patients from GA and 48 (28.7%) from BAL (p<0.05). The overall bacteriologic yield combining both procedures was 41.9% (p=0.037). Conclusions: To our knowledge, this is the largest study of bronchoscopic evaluation in pediatric pulmonary TB and the first to explore risk factors for AI. AI was found more significantly in the patients with resistance to TB treatment. Combining GA and BAL improve bacteriologic yield. FB is valuable in the management of childhood pulmonary TB. ER -