UTILITY OF FIBEROPTIC BRONCHOSCOPY IN SUSPECTED CASES OF PULMONARY TUBERCULOSIS WHO ARE SPUTUM SMEAR NEGATIVE

Hiren Vadhiya; Arvind Pandey; Arvind Daxini; Parin Patel

Volume : VII, Issue : XI, November - 2018

UTILITY OF FIBEROPTIC BRONCHOSCOPY IN SUSPECTED CASES OF PULMONARY TUBERCULOSIS WHO ARE SPUTUM SMEAR NEGATIVE

Hiren Vadhiya, Arvind Pandey, Arvind Daxini, Parin Patel

Abstract :

Introduction:

Fieoptic Bronchoscopy provides various types of specimens (aspirates, ushes and biopsies) for confirming the diagnosis in sputum smear negative pulmonary tuberculosis have yielded conflicting results. Hence this study has been undertaken to evaluate the significance of fiberoptic onchoscopy in the diagnosis of Pulmonary Tuberculosis among patients who have chest X–ray suggestive but remain undiagnosed because of a negative sputum smear for AFB, hence aiding in the early diagnosis and thereby prompt & accurate treatment of such patients.

Methods:

The study will include patients strongly suspecting pulmonary tuberculosis by radiological or clinical features but whose sputum smears are negative for tuberculosis; attending Respiratory Medicine Department in a tertiary care hospital. Broncho–alveolar lavage (BAL) samples from such 53 patients with clinical and radiographic findings suggestive of PTB with 2 consecutive Sputum smear negative for AFB were processed for diagnosis of pulmonary tuberculosis.

Result:

The incidence of diagnosis of pulmonary tuberculosis through fiber optic onchoscopy was found high in age 20–49 with high incidence in males, most of patients not having past history of tuberculosis and duration of symptoms < 1 month. Post onchoscopy Sputum Smear was positive in 8(15.09%) patients out of 53 patients, BAL AFB Z–N Stain positive in 10(18.86%) patients out of 53 patients and BAL CBNAAT (MTB) Positive in 38(71.69%) patients and BAL culture(liquid) positive for AFB in 30(56.60%) patients out of 53 patients.

Conclusion:

It was observed that oncho–alveolar lavage analysis for detection of AFB is much more reliable, rapid and accurate diagnosis in suspected cases of pulmonary tuberculosis who are sputum smear negative and chest x–ray suggestive of pulmonary tuberculosis.