Article

Fiberoptic bronchoscopy for the rapid diagnosis of smear-negative pulmonary tuberculosis.

BMC Infectious Diseases (impact factor: 3.12). 06/2012; 12(1):141. DOI:10.1186/1471-2334-12-141 pp.141
Source: PubMed

ABSTRACT BACKGROUND: This study was aimed to investigate the diagnostic value of fiberoptic bronchoscopy (FOB) with chest high-resolution computed tomography (HRCT) for the rapid diagnosis of active pulmonary tuberculosis (PTB) in patients suspected of PTB but found to have a negative sputum acid-fast bacilli (AFB) smear. METHODS: We evaluated the diagnostic accuracy of results from FOB and HRCT in 126 patients at Gangnam Severance Hospital (Seoul, Korea) who were suspected of having PTB. RESULTS: Of 126 patients who had negative sputum AFB smears but were suspected of having PTB, 54 patients were confirmed as having active PTB. Hemoptysis was negatively correlated with active PTB. Tree-in-bud appearance on HRCT was significantly associated with active PTB. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FOB alone was 75.9%, 97.2%, 95.3%, and 84.3%, respectively, for the rapid diagnosis of active PTB. The combination of FOB and HRCT improved the sensitivity to 96.3% and the NPV to 96.2%. CONCLUSIONS: FOB is a useful tool in the rapid diagnosis of active PTB with a high sensitivity, specificity, PPV and NPV in sputum smear-negative PTB-suspected patients. HRCT improves the sensitivity of FOB when used in combination with FOB in sputum smear-negative patients suspected of having PTB.

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Keywords

54 patients
 
active PTB
 
active pulmonary tuberculosis
 
AFB
 
chest high-resolution computed tomography
 
diagnostic accuracy
 
diagnostic value
 
fiberoptic bronchoscopy
 
FOB
 
Gangnam Severance Hospital
 
HRCT
 
negative predictive value
 
negative sputum acid-fast bacilli
 
positive predictive value
 
rapid diagnosis
 
specificity
 
sputum smear-negative patients
 
sputum smear-negative PTB-suspected patients
 
Tree-in-bud appearance
 
useful tool