Diagnostic Yield of Bronchoscopic Alveolar Lavage Gene Xpert MTB/Rif in Smear Negative Clinico-Radiologically Suspected Case of Pulmonary Tuberculosis

Authors

  • Bidesh Bista Department of Medicine, Civil Service Hospital, Kathmandu, Nepal https://orcid.org/0000-0003-4232-3871
  • Niraj Karmacharya Department of Medicine, Civil Service Hospital, Kathmandu, Nepal
  • Ram Hari Ghimire Department of Medicine, Nobel Medical College Teaching Hospital, Biratnagar, Nepal
  • Pradeep Shrestha Department of Medicine, Civil Service Hospital, Kathmandu, Nepal
  • Deepak Poudel Department of Medicine, Civil Service Hospital, Kathmandu, Nepal
  • Janer Kurumbang Department of Medicine, Civil Service Hospital, Kathmandu, Nepal
  • Manoj Mahato Department of Medicine, Civil Service Hospital, Kathmandu, Nepal
  • Deebya Raj Mishra Department of Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

DOI:

https://doi.org/10.3126/jonmc.v11i1.45735

Keywords:

Bronchoalveolar lavage, Bronchoscopy, Tuberculosis

Abstract

Background: Early diagnosis of pulmonary tuberculosis is difficult but dreaded complications like cavitations, abscess, disseminations and fibrosis of lung parenchyma can be avoided. Sputum microscopy is still the most available test for diagnosis of pulmonary tuberculosis but sustainable number of active cases remains undiagnosed via this method alone. In strong clinico-radiological pulmonary tuberculosis patients who are sputum scarce or sputum microscopy and sputum Xpert MTB/Rif negative broncho-alveolar lavage may provide superior sample for Gene Xpert MTB/Rif in diagnosis of Pulmonary Tuberculosis.

Materials and Methods: Over 2 years period, patients with strong clinico-radiological suspicion of pulmonary tuberculosis who had sputum microscopy and sputum Xpert MTB/Rif negative were included in the study. Fibro-optic bronchoscopy was done for BAL Xpert MTB/Rif test. Base line demographic, clinical and radiological data were systematically analysedby SPSS software version 17.

Results: 64 patients were included in the study with mean age 41 ± 10.52 years. The most common symptoms were cough, sputum production and weight loss with frequency of 58 (90.6%), 31 (48.4%) and 21 (32.11%) patients respectively. The most common CT scan findings were consolidation, cavitation and tree in bud pattern. BAL Xpert MTB/Rif was positive in 11 (17.18%) patients. According to the CT findings BAL Xpert MTB/Rif was most commonly present in patients presenting with cavitary lung disease.

Conclusion: Eleven patients had BAL gene Xpert/Rif positive out of 64 patients who were sputum scarce or had both microscopy and sputum gene Xpert/Rif negative. Bronchoscopy BAL Xpert/Rif could provide an additional diagnostic test in these groups of patients.  

Downloads

Download data is not yet available.
Abstract
80
PDF
76

Author Biography

Bidesh Bista, Department of Medicine, Civil Service Hospital, Kathmandu, Nepal

Registrar

Downloads

Published

2022-06-29

How to Cite

Bista, B., Karmacharya, N., Hari Ghimire, R., Shrestha, P., Poudel, D., Kurumbang, J., Mahato, M., & Raj Mishra, D. (2022). Diagnostic Yield of Bronchoscopic Alveolar Lavage Gene Xpert MTB/Rif in Smear Negative Clinico-Radiologically Suspected Case of Pulmonary Tuberculosis. Journal of Nobel Medical College, 11(1), 38–42. https://doi.org/10.3126/jonmc.v11i1.45735

Issue

Section

Original Articles