DIAGNOSTIC VALUE OF FIBREOPTIC BRONCHOSCOPY IN SMEAR NEGATIVE PULMONARY TUBERCULOSIS
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2017, Vol 5, Issue 4
Abstract
This retrospective study was carried out in the Department of Chest and Tuberculosis, Government medical College and Rajindra Hospital , Patiala.The aims and the objective of the study was to confirm the diagnosis in the smear negative cases of pulmonary tuberculosis so as to put them on anti-tubercular treatment by bacteriological confirmation. Material and Methods- In fifty clinicaly and radiologicaly suspected cases of pulmonary tuberculosis who were negative thrice on direct smear examination for acid fast bacilli and patients who did not expectorate at al, broncoscopy was done . Al the patients had no previous history of anti-tubercular drugs in the past or anti tubercular drugs , if taken duration was not more than 15 days. Detailed history and clinical examination of the patients was conducted with routine investigations. Prebronchoscopic sputum, post bronchoscope sputum and X-ray chest were got done, Bronchoscopic specimens such as bronchial aspirates, the lavage fluid, bronchial brushings and also post bronchoscope sputum was sent for direct smear examination (Ziehl Neelsen Method) for confirmation of the disease. Results: In this study, cough was the predominant complaint followed by fever and other constitutional symptoms suggestive of the disease as anorexia, fatigue,night sweats. Through bronchoscope,Mucosal ulceration was in 5 (10%) )bronchial secretions in 10 (20%) , mucosal oedema and ulceration in & bronchial stenosis in 1 (2%) and mild haemoptysis in 4 (8)patients were visualised.10 (20%)specimens of bronchial aspirates or secretions were found to be positive for acid fast bacilli, 12 (24%) were positive by bronchial brushings, 1 (2%) on bronchial washing with an overal positivity was obtained in 23 (46%) patients 10 (20%)patients were confirmed for tubercle bacilli by post- bronchoscopic sputum examination. Conclusion: This study confirms that bronchoscopy was a valuable tool and is a undisputed diagnostic technique in the diagnosis of PTB in patients who are either negative on direct smear examination or did not expectorate at al, thus achieving more positive yield .
Authors and Affiliations
SK Bansal, GC Ahir, SPS Bagga, Baltej Singh
Keywords
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