Role of Fibreoptic Bronchoscopy in Smear Negative Re-Treatment Pulmonary Tuberculosis

Navaneetha Krishnan, S (2015) Role of Fibreoptic Bronchoscopy in Smear Negative Re-Treatment Pulmonary Tuberculosis. Masters thesis, Stanley Medical College, Chennai.


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BACK GROUND: Diagnosis of sputum smear –negative retreatment pulmonary tuberculosis patients can be challenging and many patients being put on anti-tubercular treatment empirically, leading many time to avoidable risk of drug toxicity, particularly retreatment cases. Fibreoptic bronchoscopy may provide a confirmative and early diagnosis in such patients. AIM OF THE STUDY: To assess the role of fibreoptic bronchoscopy in the sputum smear–negative Retreatment pulmonary tuberculosis and compare the pre FOB sputum for LPA with FOB wash AFB culture by LJ medium. MATIERIALS AND METHODS: This is prospective study. It was conducted on 52, clinically and radio logically suspected sputum smear–negative Retreatment Pulmonary Tuberculosis patients attending Government Hospital of Thoracic Medicine, Tambaram Sanatorium. Fibreoptic bronchoscopy was performed. Bronchial wash and brush sent for AFB smear and malignant cytology. Bronchial wash for AFB culture by LJ medium, post FOB sputum for AFB smear. All patients in this study given pre bronchoscopy sputum for LPA. RESULTS: Final diagnosis of sputum smear –negative Retreatment Pulmonary Tuberculosis was made by bronchial wash AFB smear positive – 14/52 (26.92%), bronchial wash AFB Culture by LJ medium – 23/52 (44.23%), bronchial brush for AFB smear positive– 12/52 (23.07%), post FOB Sputum for AFB smear positive – 6/52 (11.53%), FOB brush for malignant cytology - 2/52 (3.85%). Pre bronchoscopy sputum for LPA deduct mycobacterium in 15 patients 15/52 (28.84 %), (in which 5 patients LPA positive, 10 patients LPA negative, culture positive). All these patients within the margin of FOB wash AFB culture positive cases. Except one patients whose pre bronchoscopy sputum LPA positive p value <0.001). Bronchial wash Bacterial c/s shows pyogenic infection in 12/52 (23%). CONCLUSION: Our study suggests that fibreoptic bronchoscopy can provide useful tool for diagnosis of sputum smear –negative Retreatment Pulmonary Tuberculosis. It may decide the CAT II ATT in these patients. It also diagnosis non tuberculous pathology like malignancy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Bronchial wash and brush ; pulmonary tuberculosis ; sputum smear negative ; fibreoptic bronchoscopy ; retreatment cases.
Subjects: MEDICAL > Tuberculosis and Respiratory Medicine
Depositing User: Punitha K
Date Deposited: 06 May 2018 04:06
Last Modified: 06 May 2018 04:06

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