Role of fiberoptic Bronchoscopy in diagnosis of smear negative pulmonary TB

Background; Several studies have demonstrated the value of bronchoscopy in individuals with a positive history of pulmonary TB but a negative sputum smear. Unfortunately, there is a lack of information on when bronchoscopy is most beneficial, Aim and objectives; To assess the use of bronchoscopy for the diagnosis of tuberculosis in patients with negative sputum smears, Subjects and methods; This study is a retrospective study, was conducted at Azhar Assiut university hospital during the period from 2020 till 2022, Result; BAL culture for M. tuberculosis was positive in 22 patients (44%), Bronchial brushing culture was positive in 14 cases (46,7%), and (post bronchoscopy sputum) was positive in 13 patients (26%), Conclusion; With a high sensitivity, specificity, PPV, and NPV, fiber optic bronchoscopy (FOB) is an effective method for the fast identification of active PTB in sputum smear-negative PTB-suspected patients. However, the main issue is that contaminated bronchoscopes might cause nosocomial transmission of tuberculosis and other infectious pathogens, so strong cleaning processes and protocols should be developed to prevent this.