GASTRIC ASPIRATION FOR DIAGNOSIS OF PULMONARY TUBERCULOSIS IN ADULT RENAL-ALLOGRAFT RECIPIENTS

Of 213 renal allgroft recipients suspected to have had pulmonary tuber culosis, 132 had sputum examinations and 14 showed acid-fast bacilli. Of the remaining 118 patients, 25 had gastric aspirations, 18 had bron choalveolar lavage, and 75 did not require further investigation becau se of spontaneous improvement or confirmation of an alternative diagno sis. While 9 of the 25 patients' gastric aspirate examination was posi tive, all the 18 who had bronchoalveolar lavage were negative for acid -fast bacilli. Eighty-one patients without expectoration had gastric a spiration directly and 14 showed acid-fast bacilli. Of the remaining 6 7 patients only 17 had bronchoalveolar lavage, of which three were pos itive for AFB and the rest did not require further testing for tubercu losis. A total of 106 patients had gastric aspiration, Acid-fast bacil lus positivity was significantly more (P<.01) in patients with abnorma l chest radiographs as compared with patients with normal chest radiog raph results. We suggest gastric aspiration for AFB in all renal trans plant recipients who have fever, scanty expectoration, and abnormal ch est radiograph with clinical suspicion of pulmonary tuberculosis.