Role of fiberoptic bronchoscopy in the rapid diagnosis of sputum smear-negative disseminated tuberculosis with pulmonary miliary infiltrates

Abstract EN

We sought to evaluate the role of bronchoscopy-related procedures such as bronchoalveolar lavage (Bal), bronchial wash (BW), bronchial brush (B brush), transbronchial biopsy (TBB), and post-bronchoscopy sputum (PBS), alone or in combination, in the rapid diagnosis of negative sputum smear disseminated tuberculosis (TB).

Methods: We performed a secondary post hoc analysis of data collected from our previous study entitled “disseminated tuberculosis among adult patients admitted to Hamad General Hospital, Qatar: a five-year hospital-based study” with a modified objective.

Results: We identified 27 patients.

Bal fluid was positive for acid-fast bacilli (aFB) smear in 7/27 (25.9%) patients and were culture-positive for Myobacterium tuberculosis in 17/27 (63.0%) cases, while BW collections were smear-positive in 9/27 (33.3%) cases and culture-positive for M.

tuberculosis in 18/27 (66.7%) cases.

TBB showed caseating granulomas in 10/16 (62.5%) cases and one case of non-caseating granuloma (6.3%).

PBS was positive for aFB in 4/8 (50.0%) patients.

The combination of these procedures enabled us to diagnose disseminated TB rapidly in 22 (81.5%) cases.

Conclusions: Bronchoscopy proved to be an effective method for the rapid diagnosis of disseminated TB in patients in whom sputum smear microscopy was negative.