Abstract
Background: Bronchoscopy has a major role in diagnosing pulmonary tuberculosis(PTB) when sputum microbiologic tests are negative. Its yield in sputum smear negative PTB is well studied, but it’s role in PTB when negative on sputum Xpert MTB/Rif test (Xpert), a more sensitive test is unclear.
Aim and Objectives: To assess the yield of bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) in Sputum Xpert negative PTB suspects against a composite reference standard (CRS).
Methods: Consecutive patients who underwent bronchoscopy from January to December 2019 and diagnosed to have PTB by CRS were identified from the bronchoscopy database. CRS was defined as positive AFB smear or Xpert or culture in BAL or TBLB or consistent HPE with clinico-radiological response to anti-TB(ATT) treatment. Yield of the tests on the bronchoscopic samples was analysed.
Results: In all, 83 patients were positive by CRS. Sensitivity of BAL smear & Xpert were 8.4% & 49.4%, TBLB smear & Xpert were 7.2% & 15.7%, BAL & TBLB culture were 44.6% & 12% and HPE was 81.9% respectively. The overlapping yield is depicted in Fig. 1. BAL or TBLB Xpert alone was positive in 9 and 2 patients respectively. In 36 patients, the sole basis of early diagnosis was HPE; of these, 7 were positive by culture subsequently.
Conclusion: In sputum Xpert negative patients requiring bronchoscopy for PTB diagnosis, HPE had the highest yield followed by BAL Xpert.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 534.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020