Title: A Comparison of yield of bronchoalveolar lavage fluid examination versus post bronchoscopic sputum examination in the diagnosis of sputum smear negative pulmonary tuberculosis
Authors: Durga Prasad Singh, Vivek Kumar Verma, Premshanker Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.182
Abstract
Aim: To compare efficacy/yield of post bronchoscopic sputum (PBS) with Bronchoalveolar lavage (BAL) in the detection of sputum smear negative pulmonary tuberculosis (SSNPTB).
Material and Methods: Bronchoscopy was done in 72 patients of SSNPTB .BAL and Post Bronchoscopy Sputum (PBS) were collected and subjected to AFB staining and culture.
Results: Tuberculosis was confirmed by smear examination for AFB in BAL fluid in 30 cases (41.6%), by post bronchoscopy sputum in 18 cases (25%). BAL culture for M. tuberculosis was positive in 37(51.3%) patients whereas PBS culture was positive in 23 (32%) patients. We were able to diagnose 39 out of 72 cases (54.2%) by combining both BAL fluid and PBS smear examination and culture for AFB. Out of these 39 cases diagnosed, BAL was more effective method with sensitivity of 94.87 % and yield of 51.38% (37/72) whereas sensitivity and yield of PBS was 58.97% and (23/72) 31.94% respectively.
Conclusions: Patients of SSNPTB must be subjected to bronchoscopy and its guided procedures before starting empirical antitubercular treatment. In our study Bronchoalveolar lavage had more sensitivity and yield as compared to post bronchoscopy sputum in detection of SSNPTB.
Keywords: Bronchoalveolar lavage fluid, Bronchoscopy, Post bronchoscopic sputum, Sputum smear negative pulmonary tuberculosis
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