Diagnostic value of endobronchial ultrasonography for pulmonary tuberculosis
- 31 July 2009
- journal article
- Published by Elsevier BV in The Journal of Thoracic and Cardiovascular Surgery
- Vol. 138 (1), 179-184
- https://doi.org/10.1016/j.jtcvs.2009.04.004
Abstract
ObjectivesWe sought to compare the diagnostic yields of acid-fast bacilli smears and Mycobacterium tuberculosis cultures in terms of bronchoalveolar lavage fluid and histologic examination of transbronchial lung biopsy specimens for pulmonary tuberculosis by using bronchoscopy with versus without endobronchial ultrasonography in patients with negative acid-fast bacilli smears or no sputum production.MethodsFrom June 2005 to July 2006, a total of 451 patients were given diagnoses of and treated for pulmonary tuberculosis in a university-affiliated hospital. Among them, 121 patients who received bronchoscopy because of sputum-negative conditions were recruited. Of these, 73 patients received bronchoscopy with endobronchial ultrasonography, and 48 patients received conventional bronchoscopy.ResultsPatients who received bronchoscopy with endobronchial ultrasonography had higher diagnostic yields of acid-fast bacilli smears (31.5% vs 12.5%, P = .018) in bronchoalveolar lavage fluid, M tuberculosis in bronchoalveolar lavage fluid (67.1% vs 47.9%, P = .024), and pathologic reports of tuberculosis in transbronchial lung biopsy specimens (32.9% vs 4.2%, P < .0001) than patients who received conventional bronchoscopy. With the aid of endobronchial ultrasonography, the overall diagnostic yield for tuberculosis by using bronchoscopic procedures (smears and cultures of bronchoalveolar lavage fluid and transbronchial lung biopsy specimens) was higher (80.8%) than for those who did not undergo endobronchial ultrasonography (58.3%, P = .035).ConclusionsThe addition of endobronchial ultrasonography to diagnostic bronchoscopy increased the sensitivity for proving the presence of tuberculosis in a population of patients with negative acid-fast bacilli smears or no sputum productionKeywords
This publication has 16 references indexed in Scilit:
- Diagnosis of Peripheral Lung Cancer With Three Echoic Features Via Endobronchial UltrasoundChest, 2007
- Prospective Study of Sputum Induction, Gastric Washing, and Bronchoalveolar Lavage for the Diagnosis of Pulmonary Tuberculosis in Patients Who Are Unable to ExpectorateClinical Infectious Diseases, 2007
- Persistence of lung inflammation and lung cytokines with high-resolution CT abnormalities during recovery from SARSRespiratory Research, 2005
- Analysis of the Internal Structure of Peripheral Pulmonary Lesions Using Endobronchial UltrasonographyChest, 2002
- Induced sputum and bronchoscopy in the diagnosis of pulmonary tuberculosisThorax, 2002
- The Relationship Between Delayed or Incomplete Treatment and All-Cause Mortality in Patients With TuberculosisJAMA, 1996
- Diagnostic role of fiberoptic bronchoscopy in suspected smear negative pulmonary tuberculosisRespiratory Medicine, 1995
- Global Epidemiology of TuberculosisJAMA, 1995
- Endobronchial sonography: feasibility and preliminary results.Thorax, 1992
- Use of the flexible fibreoptic bronchoscope in diagnosis of sputum-negative pulmonary tuberculosis.Thorax, 1982