Association Between Pulmonary Tuberculosis and Bronchial Anthracosis

Abstract

Introduction Anthracosis is black discoloration of the bronchi, which can sometimes cause anthracofibrosis. Usually, exposure to biomass fuel, air pollution, or smoke at the workplace causes it. The objective of the current study was to determine the association between tuberculosis and anthracosis. Methods Patients with chronic dyspnea, dry cough, and infiltrates or mass lesions on chest X-rays underwent bronchoscopic lavage and biopsy where needed. Patients were divided into two groups on the basis of anthracosis on bronchoscopy. Diagnosis of tuberculosis was made on bronchial wash acid-fast bacilli smear, mycobacterial culture, or Xpert Mycobacterium tuberculosis (MTB) rifampicin (RIF) assay. Results Tuberculosis was diagnosed by bronchoscopy in 68/173 (39.30%) patients with anthracosis which was significantly higher (p-value 0.020) than the control group (43/159, 27.04%). Most of the cases (54/68, 79.41%) had positive Xpert assay. The male-to-female ratio was 3:1, and all the females with anthracosis were homemakers and used biomass fuel. Conclusion Patients with exposure to smoke are prone to develop anthracosis. The presence of anthracosis is associated with the development of tuberculosis. Appropriate investigations for tuberculosis must be done in subjects undergoing bronchoscopy who are found to have anthracosis. Expanding understanding among the masses regarding the hazards of using biomass fuel in closed spaces can be a crucial measure toward diminishing the chance of developing anthracosis and the concomitant risk of tuberculosis.