DIAGNOSTIC ROLE OF FIBEROPTIC BRONCHOSCOPY IN SUSPECTED SMEAR NEGATIVE PULMONARY TUBERCULOSIS

Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) and transbro nchial biopsy (TBB) was performed in 40 patients suspected to have pul monary tuberculosis, in whom chest roentgenogram revealed minima! infi ltration and sputum smears were negative for acid-fast bacilli. Bronch oscopic procedures provided overall diagnostic yields in 47.5% (19/40) of patients. The diagnostic yield of overall bronchoscopic procedures for tuberculosis in this study was 32.5% (13/40) of patients. It cons isted of positive BAL smear in 7.5% (3/40) of patients, positive for m ycobacterial culture in 15% (6/40) of patients and TBB revealing granu loma in 17.5% (7/40) of patients. Non-tuberculosis conditions were dia gnosed by the bronchoscopic method in six patients (15%). These result s suggest that in an area with a high prevalence of tuberculosis, bron choscopic procedures should be performed in those cases in which other diagnoses such as malignancy must be ruled out. Transbronchial biopsy has a major role for early diagnosis and should be performed in all c ases, if possible.