ROLE OF FLEXIBLE FIBEROPTIC BRONCHOSCOPY IN THE DIAGNOSIS OF CHILDHOOD ENDOBRONCHIAL TUBERCULOSIS

Flexible fiberoptic bronchoscopy (FB) is a recently available tool for the investigation of pediatric pulmonary diseases. Endobronchial tube rculosis (ETB), a common complication of primary tuberculosis, has tra ditionally been diagnosed by clinical findings of bronchial obstructio n and roentgenographic evidence of bronchial involvement. A retrospect ive study was conducted to determine the incidence of endobronchial tu berculosis in children diagnosed by traditional means as having uncomp licated primary tuberculosis. Analysis of the bronchoscopic findings o f 36 children with active pulmonary tuberculosis revealed that 15 (41. 7%) had endobronchial involvement, Significantly 10 (28%) children who had no clinical or radiologic evidence of endobronchial involvement h ad endobronchial tuberculosis; 4 (11%) had early and 6 (17%) had advan ced ETB by FB. There were 6 patients with radiologic evidence suggesti ve of ETB, which was confirmed by FB in 5 patients. One child had a ob struction of a bronchus by mucus. The mucus was removed with subsequen t expansion of the distal lung segment. Complications of the procedure s were mild. FB is a safe procedure and a valuable aid for the rapid d iagnosis of ETB.