Role of BAL fluid CBNAAT for diagnosis of tuberculosis: Our experience at a tertiary care Hospital

Abstract

Background: Sputum smear negative tuberculosis can be a diagnostic challenge and there can be a dilemma in initiation of treatment, CBNAAT is one important test which gives quick results within hours plus an additional information about resistance with rifampicin, in sputum negative or nonexpectorating patients brochoalveoloarlavagae can be useful, if tested for CBNAAT made available via fiberoptic bronchoscopy. Materials and Methods: Clinico-radiological suspects of pulmonary tuberculosis who showed clinical symptoms and radiological opacities consistent with tuberculosis who were sputum negative or not expectorating sputum were included in this study with exclusion patients in whom bronchoscopy was contraindicated, smear and CBNAAT examination was done of the obtained sample. The data was then analyzed. Results: in our study of 100 patients 57 were males and 43 were females, the most common lesion detected in imaging was consolidation 44% of patients followed by cavitary lesions at 27 %. Out of 100 patients who were clinicoradiologically suspected for PTB who underwent bronchoscopy 45 were diagnosed PTB out of which 32 tested positive for CBNAAT, no rifampicin resistance was detected in those cases. Conclusion:CBNAAT obtained from broncho-alveolar samples can be of great value especially when there is a physicians dilemma to start antitubercular treatment, as there are also other conditions mimicking tuberculosis both radiologically and clinically. Hence, BAL results with CBNAAT can help to arrive at a conclusion.