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Panacea Journal of Medical Sciences


Outcome of fiberoptic bronchoscopy in sputum smear negative pulmonary tuberculosis


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Author Details: Choudhary S, Tayade BO, Kharbade S, Sontakke A, Khan S, Abraham R

Volume : 5

Issue : 1

Online ISSN : 2348-7682

Print ISSN : 2249-8176

Article First Page : 33

Article End Page : 39


Abstract

Bronchoscopy is very useful for diagnosing Sputum smear-negative pulmonary tuberculosis (SSN-PTB). Our aim is to find out the diagnostic yield of fiber optic bronchoscopy in sputum smear negative under RNTCP and radio logically suspected new cases of pulmonary tuberculosis and the complications of fiber optic bronchoscopy. A cross-sectional prospective study in which consecutive 108 patients was carried out in patients whose two sputum smear for Acid Fast Bacilli was negative and chest X-ray suggestive of pulmonary tuberculosis were included into the study. Fiber optic bronchoscopy was carried out in all patients. The yield for tuberculosis was 78 %( 85/108) i.e. made a final diagnosis of tuberculosis.29 (26.85%), 41(37.96%) and 30(27.78%) patients had positive AFB smear on Bronchial brush, Broncho alveolar lavage and post bronchoscopy sputum of which 11(12.94%), 22(25.88%) and 13(15.29%) patients had exclusive diagnosis from the respective procedures. The immediate yield combining positive smear samples from different procedures and histopathological evidence of caseating granuloma in present study is 56%(61/108). In Broncho alveolar lavage culture 57/108(57.08%) were confirmed tuberculosis diagnosis and 24(28.4%) patients had exclusive diagnosis on bronchial culture. Bilateral, advanced, and non cavitatory disease had 52, 53 and 64 patients diagnosed as pulmonary tuberculosis and was more as compared to different site, extent and type of disease on chest x-ray which were initially negative for tuberculosis. Our study suggests that fibre-optic bronchoscopy and its procedure can provide excellent material for early as well as confirming the diagnosis in suspected patients of pulmonary tuberculosis when smears of expectorated sputum do not reveal mycobacteria and helps in diagnosing different diseases and disorders having clinical picture mimicking tuberculosis.


Keywords: Sputum smear-negative, Pulmonary tuberculosis, Chest x-ray, Fiber optic bronchoscopy, Bronchial washings, Bronchial biopsies.

Doi No:-10.18231