Iranian Journal of Pathology

The Value of Bronchoalveolar Lavage in the Diagnosis of Sputum Smear-NegativePulmonary Tuberculosis

Document Type : Original Research

Authors

Novin Nikbakhsh1 1
Masomeh Bayani 2
Sepideh Siadati 3

1 Dept. of Surgery, Babol University of Medical Sciences, Babol, Iran.

2 Infectious and Tropical Disease Research Center, Babol University of Medical Sciences, Babol, Iran.

3 Dept. of Pathology, Babol University of Medical Sciences, Babol, Iran

10.7508/ijp.2015.01.005
Abstract
Background and Objectives: Sputum smear staining for acid-fast bacilli is initial approach to the diagnosis of pulmonary tuberculosis (PTB) but more than 50% of cases are sputum smear-negative. This study was aimed to investigate the diagnostic value of fiberoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis. Methods: This prospective cross-sectional study was carried out on 290 sputum smear-negative patients who were clinically suspicious for PTB in 2006-12. All patients were subjected to FOB andBAL, then BAL specimens stained and cultured. Results: Of the 290 patients, 173 cases (59.7%) were men and 117 cases (40.3%) were women with the age of 52.6±19.1 years (ranged 20-76 years). Of the total 290 BAL specimens, 110 specimens (38%) were positive for acid-fast bacilli. Sensitivity, specificity, PPV and NPV was 60%, 91%, 89% and 64%, respectively. Also, LR+ and LR- was 64.6% and 0.44%, respectively. Conclusion: FOB guided BAL is a reliable, rapid and useful method for establishing the diagnosis of smear negative PTB with minimal complications.  

Keywords

Pulmonary Tuberculosis
Bronchoalveolar Lavage
Sputum
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  • Receive Date 19 November 2013
  • Accept Date 26 March 2014

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