Fiberoptic bronchoscopy in diagnosis of patients with suspected active pulmonary tuberculosis

Patients suspected of having active pulmonary tuberculosis, in whom acid-fast bacilli (AFB) are not demonstrated on sputum direct smear, present a difficult diagnostic and therapeutic problem. Flexible fiberoptic bronchoscopy is a useful procedure in evaluating these patients. Within five years, during the period of January 1983 to December 1987, 112 patients who were suspected of having active pulmonary tuberculosis underwent fiberoptic bronchoscopy. The diagnosis of pulmonary tuberculosis was established by using this procedure in 76 per cent of cases. Immediate diagnosis were made from microscopic specimens obtained from bronchoscopy in 38 of 65 patients (58%). It is concluded that fiberoptic bronchoscopy should be performed in evaluating patients with negative smears for AFB who are clinically suspected of having tuberculosis before initiating a trial of antituberculous drugs. The technique is safe and markedly efficacious in making an immediate diagnosis and uncovering other diseases that present themselves like tuberculosis.