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Volume 5 Issue 4 (April, 2017)

Original Articles

DIAGNOSTIC VALUE OF FIBREOPTIC BRONCHOSCOPY IN SMEAR NEGATIVE PULMONARY TUBERCULOSIS
SK Bansal, GC Ahir, SPS Bagga, SK Gupta, Baltej Singh

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 .
Key words:  Fibreoptic bronchoscopy,,FOB pulmonary tuberculosis, sputum smear negative, AFB

 
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