Tuberculosis (TB) is one of the oldest and deadliest disease in the world and also major health problem, archaeological evidences from ancient civilizations have shown the existence of tuberculosis in the prehistoric era. The initial diagnostic approach to suspected case of pulmonary tuberculosis is to demonstrate mycobacterium tuberculosis in stained smears of expectorated sputum.
Aims and Objectives: To diagnose the role of Fibreoptic bronchoscopy in sputum Smear Negative Tuberculosis.
Material and Methods: This is Institutional based Prospective observational study conducted in the Department of Respiratory Medicine in Prathima Institute of Medical Sciences, Karimnagar conducted from June 2016 to November 2016. Patients were selected after screening of inclusion and exclusion criteria and taken up for the bronchoscopy. Procedure was carried out in patients with nil orally for 4 to 6 hours. Written consent was obtained from the patients. Procedure was explained to the patient in his own language. Patients were pre medicated 30 mints prior to bronchoscopy with 0.6 mg Atropine and Nebulization was done with 4% Xylocaine via ultrasonic nebulizer.
Result: The total number of patients involved in this study was 50, out of which32 males patients, i,e. 64% and 18 females patients (36%). The youngest patient was aged 18 years and the oldest was 72 years. 34 (68%) patients had unilateral lesions (right + left) and 16 (32%) had bilateral lesions. 12 (24%) had cavitary lesion, and 38 (76%) had infiltrations without cavitations on chest radiography. The most common bronchoscopic finding was congestion with mild to moderate hyperemia with whitish plaques of variable size in between, and it observed in 41 (82%) cases. Bronchial washings smear for AFB was positive in 16/50 (32%) cases, out of this predominant age group that shows more positivity belongs to 15 – 30 years (42.85%) followed by 31-45 years (40.0%).
Conclusion: This study proved that Fiberoptic Bronchoscopy though little cost effective, is an effective tool in the diagnosis of sputum negative pulmonary tuberculosis. It has shown that additional yield of 38% more than direct sputum smear examination, which helps to initiate early treatment of tuberculosis to cut off the epidemiological cycle as we know one sputum positive case can infect 15 cases. So, prevention of these cases will neutralize the cost of bronchoscopy.