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Diagnostic implications of bronchial lavage in patients with pleural tuberculosis
Affiliations- Department of Pulmonology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
- Fatima Jinnah General and Chest Hospital, Quetta, Pakistan
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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.
Keywords
bronchoalveolar lavage; bronchoscopy; pleural tissue; pleural tuberculosis; Xpert assay
About this articleTitle
Diagnostic implications of bronchial lavage in patients with pleural tuberculosis
Journal
Advances in Respiratory Medicine
Issue
Article type
Research paper
Pages
389-393
Published online
2020-10-31
Page views
721
Article views/downloads
614
DOI
Pubmed
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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