Abstract
The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was undertaken to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay of bronchial lavage fluid in the workup of pleural tuberculosis patients. All patients who met the inclusion criteria of the study underwent thoracentesis, pleural biopsy, and bronchial lavage. Specimens of pleural fluid, pleural biopsy, and bronchial lavage fluid were sent for acid fast bacilli smear, culture, and Xpert assay. Bronchial lavage AFB smear, culture, and Xpert assay was positive in 9.5%, 17.9%, and 26.2% of patients, respectively. It gave an immediate diagnosis in 22 (26.2%) patients. Bronchial lavage, though not a surrogate to pleural biopsy, offers an additional approach to the early diagnosis of pleural tuberculosis in patients not producing sputum. Besides being diagnostic, this method also has epidemiologic significance in containing the tuberculosis epidemic because detecting Mycobacterium in bronchial lavage confirms that the patient is infectious.
Highlights
The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion
This study was carried out to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay in bronchial lavage in the workup of pleural tuberculosis patients
Bronchial lavage fluid was sent for AFB smear, AFB culture, and Xpert assay
Summary
Tuberculosis (TB) remains one of the most important public health problems. The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. An alternative to getting respiratory samples in such patients is by testing fluid acquired via bronchial lavage. It is a safe and minimally invasive procedure done under local anesthesia. In addition to having diagnostic value, it can be used to monitor the progress of patients who test positive and are given antituberculous treatment (ATT). Apart from these diagnostic implications, it may have epidemio-. This study was carried out to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay in bronchial lavage in the workup of pleural tuberculosis patients
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