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INDUCED SPUTUM VERSUS FIBEROPTIC BRONCHOSCOPY IN DIAGNOSIS OF PULMONARY TUBERCULOSIS

Menouffyia University, Menouffyia, Egypt

PURPOSE: Tuberculosis (TB) remains one of the deadliest diseases in the world.Cases can’t expectorate sputum constitute a major problem especially in developing countries. Therefore, the aim of this study was to compare between sputum induction (SI) using nebulized hypertonic saline and fiberoptic bronchoscopy (FOB) in the diagnosis of pulmonary TB in clinically and radiologically suspected cases.

METHODS: This study included 30 patients(17 males and 13 females)with clinical and radiological suspicion of pulmonary TB. They had either dry cough or negative repeated sputum examinations for AFB. Three successive SI using nebulized hypertonic saline and FOB were done for all patients. Ziehl-Neelson stain (Z.N.) and Lowenstein-Jensen media(L.J.) were be used for the diagnosis of tuberculosis.

RESULTS: The sensitivity, specificity and accuracy of SI compared with bronchial washing using Z.N. were 80%,100% and 90% respectively.While,using L.J. media the sensitivity, specificity and accuracy of SI compared with bronchial washing were 88%, 100% and 90% respectively.The positive results of SI and post-bronchoscopic sputum were similar 22 cases (66.7%). There was no significant difference (P>0.05) between SI, 20 cases (66.7)and bronchial brushing,23 case (76.7) in diagnising pulmonary TB. The third SI sample is the most significant sample in detecting AFB (19 cases).

CONCLUSION: Sputum induction is an easy, effective, cheap and non-invasive procedure for the diagnosis of pulmonary TB compared to FOB. Also, SI is very suitable diagnositic technique where FOB isnot available.

CLINICAL IMPLICATIONS: Sputum induction must be done to every patient with clinical and radiological suspecion of pulmonary TB who can’t expectorate sputum or their sputum were negative for AFB. Fiberoptic bronchoscopy should be postponed until three induced sputum samples proved to be negative for AFB.

DISCLOSURE: Amr Darwish, None.