Diagnostic Value of Fiberoptic Bronchoscopy in Suspected Pulmonary Tuberculosis in the State of Qatar

摘要

To assess the diagnostic value of fiberoptic bronchoscopy (FOB) in patients with abnormal chest radiographs suggestive of pulmonary tuberculosis (PTB) but with negative sputum smears for acid fast bacilli (AFB), a retrospective study was made of all such cases referred to the Pulmonary Diseases Service at Hamad Medical Corporation between July 1997 and June 2000. It included patients unable to produce any sputum sample. From 193 FOB procedures, active pulmonary tuberculosis was diagnosed in 58 patients (30 %). The diagnosis was confirmed either by finding acid fast bacilli in a smear or by culture of bronchial washings or bronchoalveolar lavage (BAL), or by demonstrating caseating granulomata on transbronchial or endobronchial biopsy. In 19 of58 (33%) positive cases, the diagnosis was rapidly established by demonstrating AFB in smears of bronchial aspirate or by positive histopathology. It is concluded that FOB is still the gold-standard procedure in the diagnosis of pulmonary tuberculosis in those patients in whom the diagnosis cannot be established by sputum examination, thus allowing early diagnosis in a significant proportion of them. The results are in agreement with similar studies.