Fibreoptic bronchoscopy in smear-negative pulmonary tuberculosis

Area of Science:

• Pulmonology
• Microbiology
• Infectious Diseases

Background:

• Pulmonary tuberculosis diagnosis can be challenging in smear-negative cases.
• Early and accurate diagnosis is crucial for effective treatment and control of tuberculosis.

Purpose of the Study:

• To evaluate the diagnostic yield of different bronchoscopy techniques for smear-negative pulmonary tuberculosis.
• To compare the effectiveness of bronchial brush smears, aspirate smears, and biopsy in diagnosing tuberculosis.

Main Methods:

• Fifty patients with smear-negative pulmonary tuberculosis underwent fiberoptic bronchoscopy.
• Samples analyzed included bronchial aspirate smears, post-bronchoscopic sputum smears, bronchial biopsy, and brush smears.
• Diagnostic yield and comparison of techniques were statistically analyzed.

Main Results:

• Brush smears were positive in 28 patients, being the sole positive diagnostic method in ten cases.
• Bronchial aspirate smears and post-bronchoscopic sputum smears showed lower positivity rates.
• Bronchial biopsy yielded positive results in 9 out of 30 patients.
• Brush smears demonstrated a significantly higher yield compared to aspirate smears (p<0.01) and sputum smears (p<0.01).
• Rapid diagnosis was achieved in 36 patients, with a definitive diagnosis in 45 patients upon culture results.

Conclusions:

• Bronchial brush smears are highly effective for diagnosing smear-negative pulmonary tuberculosis.
• This technique offers a significant diagnostic advantage over conventional methods like bronchial aspirate smears and sputum analysis.
• Utilizing brush smears, especially from caseous material, enhances the rapid detection of tuberculosis.