PT  - JOURNAL ARTICLE
AU  - Raj Kumar
AU  - Nitesh Gupta
TI  - Role of fibreoptic bronchoscopy in early diagnosis of sputum smear negative pulmonary tuberculosis
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2609
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2609.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2609.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background: Fiberoptic bronchoscopy (FOB) is an alternative method to obtain respiratory specimens for diagnosis in clinical and radiological suspected sputum smear negative pulmonary tuberculosis (SSN-PTB).Aim and Objective: The aim is to evaluate the diagnostic yield of various FOB procedures in SSN-PTB cases.Method: 118 SSN-PTB, HIV negative patients (16-60 yrs; 71 males) underwent FOB for purpose of diagnosis. The FOB procedures performed were bronchial aspirate (BA), bronchoalveolarlavage (BAL), endobronchial (EBLB) and transbronchial biopsies (TBLB). Transbronchial needle aspiration (TBNA) was carried out in appropriate cases. The diagnosis of PTB was established in presence of either an acid fast bacilii on microscopy or positive culture or a caseating granuloma in biopsy specimen.Results: Of 116 SSN-PTB suspected patients, 88 (75.86%) were diagnosed to be pulmonary tuberculosis. The predominant symptom was cough (86.2%); hemoptysis present in 14%. The commonly observed radiological patterns were cavitation (52.1%), consolidation (38.2%), multiple nodules (31.4%) and lymphadenopathy (19.6%). On inspection of tracheo-bronchial tree, endobronchial erythema (16.2%) and nodules (9.4%) were observed. The BAL from the suspected segment was diagnostic in 63 and bronchial aspirate in 29 patients, achieving a combined yield of 72.4%. The diagnostic yields of the biopsies demonstrating caseating granulomas were EBLB (8.7%), TBLB (13.5%) and TBNA (30.6%). The collective diagnostic yield of a FOB in SSN-PTB cases was 75.8%.Conclusion:In tuberculosis endemic region, bronchoscopy may prove to be a beneficial technique in the assessment of suspected cases, which are sputum smear-negative.