Abstract
Introduction: Patients with suspected pulmonary tuberculosis and negative sputum samples constitute a problem that is not uncommon in clinical practice. Fiberoptic bronchoscopy is an alternative method of collecting respiratory samples that plays an important role in such cases.
Objectives: The aim of this study was to assess the yield of bronchoalveolar lavage in early diagnosis of negative sputum smear pulmonary tuberculosis and its value in obtaining other diagnoses.
Methods: The study was conducted for 27 months in a central hospital. Bronchoscopy was performed in patients after three consecutive negative sputum smears for acid-fast bacilli, in order to obtain bronchoalveolar lavage samples. Written informed consent was obtained.
Results: The overall diagnostic yield of fiberoptic bronchoscopy was 39% (39 out of 100) and included 18% of other diagnosis than tuberculosis with 3 cases of malignant disease. Through bronchoalveolar lavage smear and nucleic acid amplification test for M. tuberculosis an immediate diagnosis was obtained in 57.1%. Median time to positive culture was lower in bronchoalveolar lavage compared to sputum (p=0.001). The global resistance to antituberculosis drugs was 19%.
Conclusions: Bronchoalveolar lavage samples were helpful in the management of smear negative pulmonary tuberculosis. The procedure had good diagnostic yield and contributed to the diagnosis of other diseases.
- © 2011 ERS
