UTILITY OF BRONCHOSCOPY IN SPUTUM SMEAR NEGATIVE SUSPECTED TUBERCULOSIS PATIENTS

Background: Pulmonary tuberculosis is highly prevalent in India and in routine its diagnosis conrmation is based on sputum microscopic and culture examinations. Many time either patients are unable to expectorate adequate sputum or staining results in negative results of mycobacterium tuberculosis despite clinical suspicion. Those Sputum smear negative pulmonary tuberculosis patients are diagnosis dilemma faced by clinicians. Bronchoscopy could be very helpful in diagnosing these cases which have no sputum or whose sputum smear is negative for acid fast bacilli. Objective of the our study was to analyze the utility of bronchoscopy in sputum smear negative clinicoradiological suspected cases of pulmonary tuberculosis. Methods: A total of 60 patients were selected for study between age group of 18-55 years. The chosen patients were clinical or radiological suspects of pulmonary tuberculosis. We have performed Bronchoscopy under local anesthesia. 0.9% saline is used for Bronchoalveolar lavage. Bronchoalveolar lavage was analyzed with Gram and Ziehl-Neelson stain, AFB and aerobic cultures and nucleic acid amplications, cytology also done for brushing slides obtained. Results: All patients tolerated procedure well. No serious complications related to the procedure are noted after 48 hours of procedure. 31 out of 60 patients (51%) were conrmed tuberculosis using BAL AFB stain, cytology, NAAT, AFB Culture, while 9 out of 60 (15%) alternative diagnosis is made. Conclusions Our study suggest that in tuberculosis endemic area with high prevalence, bronchoscopic procedures considered to be done in suspect tuberculosis patients to conrm the infection with mycobacterium and to rule out other possible etiologies. It has signied importance of bronchoscopy in those areas even when patient is sputum smear and culture negative but clinical or radiological suspect of Tuberculosis