open access

Vol 88, No 5 (2020)
Research paper
Submitted: 2020-04-16
Accepted: 2020-07-23
Published online: 2020-10-31
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Diagnostic implications of bronchial lavage in patients with pleural tuberculosis

Kamran Khan Sumalani1, Nousheen Akhter1, Maqbool Ahmed2, Dimple Chawla1, Nadeem Ahmed Rizvi1
DOI: 10.5603/ARM.a2020.0149
·
Pubmed: 33169809
·
Adv Respir Med 2020;88(5):389-393.
Affiliations
  1. Department of Pulmonology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
  2. Fatima Jinnah General and Chest Hospital, Quetta, Pakistan

open access

Vol 88, No 5 (2020)
ORIGINAL PAPERS
Submitted: 2020-04-16
Accepted: 2020-07-23
Published online: 2020-10-31

Abstract

Introduction: The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was undertaken to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay of bronchial lavage fluid in the workup of pleural tuberculosis patients.
Material and methods: All patients who met the inclusion criteria of the study underwent thoracentesis, pleural biopsy, and bronchial lavage. Specimens of pleural fluid, pleural biopsy, and bronchial lavage fluid were sent for acid fast bacilli smear, culture, and Xpert assay.
Result: Bronchial lavage AFB smear, culture, and Xpert assay was positive in 9.5%, 17.9%, and 26.2% of patients, respectively. It gave an immediate diagnosis in 22 (26.2%) patients.
Conclusion: Bronchial lavage, though not a surrogate to pleural biopsy, offers an additional approach to the early diagnosis of pleural tuberculosis in patients not producing sputum. Besides being diagnostic, this method also has epidemiologic significance in containing the tuberculosis epidemic because detecting Mycobacterium in bronchial lavage confirms that the patient is infectious.

Abstract

Introduction: The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was undertaken to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay of bronchial lavage fluid in the workup of pleural tuberculosis patients.
Material and methods: All patients who met the inclusion criteria of the study underwent thoracentesis, pleural biopsy, and bronchial lavage. Specimens of pleural fluid, pleural biopsy, and bronchial lavage fluid were sent for acid fast bacilli smear, culture, and Xpert assay.
Result: Bronchial lavage AFB smear, culture, and Xpert assay was positive in 9.5%, 17.9%, and 26.2% of patients, respectively. It gave an immediate diagnosis in 22 (26.2%) patients.
Conclusion: Bronchial lavage, though not a surrogate to pleural biopsy, offers an additional approach to the early diagnosis of pleural tuberculosis in patients not producing sputum. Besides being diagnostic, this method also has epidemiologic significance in containing the tuberculosis epidemic because detecting Mycobacterium in bronchial lavage confirms that the patient is infectious.

Get Citation

Keywords

bronchoalveolar lavage; bronchoscopy; pleural tissue; pleural tuberculosis; Xpert assay

About this article
Title

Diagnostic implications of bronchial lavage in patients with pleural tuberculosis

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 5 (2020)

Article type

Research paper

Pages

389-393

Published online

2020-10-31

DOI

10.5603/ARM.a2020.0149

Pubmed

33169809

Bibliographic record

Adv Respir Med 2020;88(5):389-393.

Keywords

bronchoalveolar lavage
bronchoscopy
pleural tissue
pleural tuberculosis
Xpert assay

Authors

Kamran Khan Sumalani
Nousheen Akhter
Maqbool Ahmed
Dimple Chawla
Nadeem Ahmed Rizvi

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