Sputum versus bronchial washings for diagnosis of pulmonary tuberculosis- a prospective study of 53 patients

Abstract

Background: Tuberculosis is a major global public health problem. It is caused by mycobacterium tuberculosis and it is a leading cause of death in developing countries like India. WHO recommends the detection of acid fast bacilli in sputum as the initial diagnosis of pulmonary TB. Tuberculosis is spread from person to person through air by droplet nuclei. So, early detection and prompt treatment of tuberculosis is main cornerstone to prevent transmission into community. Bronchial washing is very helpful for early detection of mycobacterium tuberculosis.Methods: This is a prospective study of 53 sputum smear negative patients underwent for bronchoscopy. After a detailed medical history and physical examination, Patients with a negative sputum smear AFB examination and a strong clinco-radiological suspicion of pulmonary tuberculosis were then counseled, consented and subjected to fiber-optic bronchoscopy with bronchial washings and bronchial biopsy in case of endobronchial lesions.Results: Our study showed mean age of patient is about 43.49 year and has predominantly male patients. Most cardinal symptoms were fever (83%) and cough (74%). Most radiological findings were consolidation and cavity lesion accordingly. Sputum culture was positive in 14 (26%) patients out of 53 patients and bronchial washing smear positive for AFB in 30 (57%) patients and bronchial washing culture positive for AFB in 40 (75%) patients out of 53 patients.Conclusions: Bronchial washings analysis for detection of AFB is much more reliable in comparison to direct smear microscopy and direct sputum culture examination.

Diagnostic Role of Endobronchial Washings and Biopsy in Smear Negative Pulmonary Tuberculosis and Its Correlation With High Resolution Computed Tomography Chest Findings

“…Diagnosis of pulmonary tuberculosis relies on bacteriological examination that includes sputum smear microscopy and culture however, the diagnostic yield of these tests is low with sensitivity ranging from 25-45% 3 . There is a good proportion of patients of pulmonary tuberculosis who are smear negative that is, either they don't expectorate or are sputum negative for AFB.…”