ROLE OF FIBEROPTIC BRONCHOSCOPY IN DIAGNOSIS OF SUSPECTS OF PULMONARY TUBERCULOSIS
Dr. Mamata Heda*, Dr. Pankaj Wagh*, Dr. Shivam Puniani, Dr. Jigneshkumar Patel, Dr. Rakesh Rajpurohit, Dr. Ravindra Chordia, Dr. Gaurav Dubey, Dr. Pankaj Gujar and Dr. Anil Rohankar
ABSTRACT
Introduction: TUBERCULOSIS is a disease caused by Mycobacterium tuberculosis (MTB) which is a gram positive, aerobic, acid and alcohol fast bacillus. India has the maximum number of tuberculosis cases worldwide accounting for one fourth of the global TB cases. The diagnosis of pulmonary TB can be obtained from microscopy and culture of a number of different sources including regular sputum, induced sputum, gastric washings and bronchoscopy. Fiberoptic bronchoscopy can provide excellent material for diagnosis of suspected cases of pulmonary TB when smear of expectorated sputum do not reveal mycobacteria. Aims & Objectives: To assess the diagnostic role of fiberoptic bronchoscopy in diagnosis of suspect cases of pulmonary tuberculosis. Material And Methods: After consent, 82 patients with sputum smear negative for AFB and chest x ray suggestive of pulmonary TB, underwent fiberoptic bronchoscopy. Bronchoalveolar lavage(BAL), Bronchial brushings, Transbronchial lung biopsy(TBLB) was done and sample analysed by smear microscopy, CBNAAT and Cytopathology. Results: The final diagnosis of PTB was established in 51/82 (62%) cases by combining all Bronchoscopic aided procedures. The sensitivity of BAL CBNAAT, BAL fluid direct smear, Bronchial Brushing smear and TBLB are 90.2%, 41.2%, 23.5% and 7.8% respectively. CONCLUSION: Flexible fiberoptic bronchoscopy is a useful tool in early diagnosis of pulmonary tuberculosis in sputum smear negative patients. Bronchoscopy with various Bronchoscopic aided procedures reveals a higher bacteriological confirmation of diagnosis in patients with strong clinical and radiological evidence suggestive of pulmonary tuberculosis.
Keywords: Mycobacterium Tuberculosis, Fiberoptic Bronchoscopy, Bronchoalveolar Lavage(BAL), CB NAAT, Transbronchial lung biopsy (TBLB).
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