Rapid diagnosis of suspected pulmonary tuberculosis by fiberoptic bronchoscopy

Fiberoptic bronchoscopy was performed on 65 patients suspected of having active pulmonary tuberculosis, who were either sputum smear-negative or had no sputum to test. Bronchial aspirate was smear positive in 25 of 65 patients (38%); postbronchoscopy sputum was smear positive in 15 of 60 (37%) and there was bronchial biopsy evidence of tuberculosis in 33 of 57 (58%). Biopsy was particularly useful; it provided the exclusive diagnosis in 12% of cases. When the 3 methods were combined, a diagnosis of tuberculosis was made within 3-4 days in 42 of 65 patients (65%). Taking culture results into consideration, we made a definitive diagnosis in 61 of 65 patients (94%). Thirteen patients had atypical radiographic shadows and 7 had unsuspected co-existing bronchogenic carcinoma. No major complication developed after bronchoscopy. Our results are compared with those of 3 other reported series.