ROLE OF FIBER-OPTIC BRONCHOSCOPY IN SPUTUM SMEAR NEGATIVE PULMONARY TUBERCULOSIS

Abstract

Objective: To evaluate the utility of fiberoptic bronchoscopy in sputum smear negative PTB patients.

Material and Methods: A total of 66 adult patients with sputum smear negative for Acid Fast Bacilli (AFB) and chest X-ray suggestive of pulmonary tuberculosis underwent fiberopticbronchoscopy (FOB). A thorough examination of bronchial tree was carried out and bronchoalveolarlavage (BAL) was taken and was sent for Ziehl-Neelsen staining, MGIT960 TBculture, pyogenicand fungal culture. Bronchial brushing, endo-bronchial and transbronchial lung biopsy(TBLB) wherever indicated were performed and Ziehl-Neelsen staining was performed and post bronchoscopy sputum(PBS) was also sent for Ziehl-Neelsen stain.Results are summarized in tables and percentages. Quantitative data is summarized using means& standard deviation. Cross tabulation with outcome variable of interest was done using statistical software Epi-info version 7 (7.1.1.0). A p-value of less than 0.05 was considered statistically significant.

Results: Males constituted majority of our study population. The most common age group involved in the study was 18-28 years (36.3%). cough was the most common symptom reported by 62 patients (93.93%). The past history of PTB was present 6 patients (9.09%).Majority of study population, 39 patients (59.09%) had unilateral lesion on CXR. Out of 66 clinically suspected SSN-PTB patients, 52 patients (78.7%) were finally diagnosed as having active PTB. The diagnosis other than PTB was established in 6 (9.09%) cases, which included 3 cases of fungal (Candida) pneumonia and 3 cases of bacterial (pseudomonas species, citrobacter species, serratiamarsecens) pneumonia.

Conclusions: FOB and various bronchoscopy guided procedures can provide a rapid and definitive diagnosis of PTB in sputum negative patients.