RT Journal Article
SR Electronic
T1 Use of fibreoptic bronchoscopy in early diagnosis of sputum smear-negative pulmonary tuberculosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p4392
VO 38
IS Suppl 55
A1 Hoi-Yee Kwan
A1 Susanna Lau
A1 Kah-Lin Choo
A1 Wai-Kei Lam
A1 Chun-Man Wong
A1 Chin-Wing Yu
A1 Tze-Lun Wong
A1 Wing-Yan Chu
A1 Kwan-Keung Wong
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p4392.abstract
AB 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.