Abstract
Introduction: Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. However, its indication has not been standardized. Therefore, we conducted a retrospective study to assess the diagnostic value of bronchial washing in patients suspected with pulmonary TB. Methodology: A retrospective analysis was performed on patients diagnosed with pulmonary TB in Kosin university gospel hospital, a tertiary hospital with 969 beds in South Korea, from March 2017 to December 2018. We obtained three serial sputum samples for acid-fast bacilli (AFB) smear and culture, and all patients underwent bronchoscopy with bronchial washing for AFB smear and culture. Results: Fifty-six patients were enrolled in the study. Smear-negative pulmonary TB (SNPT) was diagnosed in 42/56 (75%) patients. Among the patients with smear-positive sputum, 14/14 (100%) showed culture-positive sputum, while smear- and culture-positive bronchial washing were seen in 7/14 (50%) and 12/14 (85.7%) patients, respectively. Among the patients with SNPT, 17/42 (40.47%) had culture-negative sputum and were diagnosed using the bronchoscopic washing. Conclusions: For patients with smear-negative sputum, it is necessary to perform bronchoscopic washing to increase the diagnostic rate of pulmonary TB. To control the transmission of pulmonary TB, it is necessary to use a fast and accurate examination method.
Highlights
Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative
The aim of this study was to assess the diagnostic value of bronchial washing in the patients suspected with pulmonary TB who are unable to expectorate or have smear-negative sputum
Pulmonary TB was diagnosed based on acid-fast bacilli (AFB) smear-positive sputum in 14/56 (25%) patients
Summary
Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. Among the patients with SNPT, 17/42 (40.47%) had culture-negative sputum and were diagnosed using the bronchoscopic washing. Conclusions: For patients with smear-negative sputum, it is necessary to perform bronchoscopic washing to increase the diagnostic rate of pulmonary TB. The World Health Organization defines smear-negative pulmonary TB (SNPT) as a case with at least two sputum samples negative for acid fast bacilli (AFB) and either a positive culture for M. tuberculosis or the presence of radiographic abnormalities consistent with TB [4]. The aim of this study was to assess the diagnostic value of bronchial washing in the patients suspected with pulmonary TB who are unable to expectorate or have smear-negative sputum
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