Abstract
Background: Pulmonary tuberculosis (PTB) is a major health problem worldwide. Rapid diagnosis allows early treatment and infection control, which is hard to achieve among sputum smear-negative (SSN) subjects. Different bronchoscopic sampling techniques have been used but their roles remain unclear.
Objectives: To evaluate the value of fibreoptic bronchoscopy in the diagnosis of PTB among SSN patients in a regional hospital in Hong Kong.
Methods: Medical records of 22 patients, who have underwent bronchoscopy in the North District Hospital, HKSAR, in 2009, and were later diagnosed of having PTB, were reviewed. Results of their pulmonary specimens were recorded. The exclusive diagnostic test was identified.
Results: Bronchoalveolar lavage (BAL) was performed in all 22 cases. Positive acid-fast smear and culture were obtained in three (13.6%) and six cases (27.3%) respectively, providing the exclusive means of diagnosis for four cases (three from smear, one from culture). Molecular study from BAL was done in 14 cases, in which five cases were test positive (35.7%), two cases gave exclusive diagnosis. Transbronchial lung biopsy (TBLB) was performed in 19 cases. All were sent for histology, while six were sent for acid-fast bacilli (AFB) culture. Histology gave positive results in five cases (26.3%), which was the exclusive means of diagnosis for two. TBLB AFB smear was all negative, but three gave positive AFB culture. Among them, one provided exclusive diagnosis.
Conclusion: While sputum examination remains the cornerstone in diagnosing PTB, fibreoptic bronchoscopy plus various sampling techniques served as a useful adjunct to optimize the diagnostic yield, especially among those SSN cases.
- © 2011 ERS
