Abstract
Tuberculosis is a major public health problem. Almost 30% of cases of tuberculosis are known to be sputum smear negative. There is a diagnostic dilemma in such cases leading to inadvertent delays in management of these cases. The present study was planned to assess the role of bronchoscopy in immediate diagnosis of smear negative pulmonary tuberculosis. The present study is a retrospective analysis of 132 sputum smear negative tuberculosis suspects who underwent bronchoscopic evaluation during the period 2002-2013. The diagnosis of tuberculosis was based on the finding of bacilli in aspirate or in tissue biopsy or the demonstration of caseous necrosis on tissue biopsy. The present study showed that bronchoscopy could lead to immediate, accurate diagnosis in 68.2% of suspected smear negative cases. Bronchial aspirate and bronchoalveolar lavage alone were diagnostic in 51.5% of such cases while tissue biopsy added to the yield in another 16.5% cases. The results of the present study suggests an important place of bronchoscopy in immediate diagnosis of suspected smear negative tuberculosis, thus avoiding inadvertent delays in diagnosing and instituting appropriate treatment.
Highlights
Tuberculosis is a major public health problem especially in developing countries like India
A study by Bachh et al [4] showed bronchoscopy was helpful in diagnosis of sputum smear negative pulmonary tuberculosis in 83.33% cases, with immediate diagnosis possible in 48.33% patients
Culture results were not evaluated in the study as the primary aim of the study was to assess the role of bronchoscopy in immediate diagnosis of tuberculosis
Summary
Tuberculosis is a major public health problem especially in developing countries like India. On epidemiological analysis of tuberculosis in India, prevalence per million reduced from 4,650 in year 1990 to 2,300 in 2012 [2]. Almost 30% of cases of tuberculosis are known to be sputum smear negative. The present study was planned to assess the role of bronchoscopy in immediate diagnosis of smear negative pulmonary tuberculosis. Material and methods: The present study is a retrospective analysis of 132 sputum smear negative tuberculosis suspects who underwent bronchoscopic evaluation during the period 2002–2013. Results: The present study showed that bronchoscopy could lead to immediate, accurate diagnosis in 68.2% of suspected smear negative cases. Conclusions: The results of the present study suggests an important place of bronchoscopy in immediate diagnosis of suspected smear negative tuberculosis, avoiding inadvertent delays in diagnosing and instituting appropriate treatment
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