Role of gastric lavage and broncho-alveolar lavage in the bacteriological diagnosis of childhood pulmonary tuberculosis.
OBJECTIVE
To compare the mycobacteriological yield from gastric lavage (GL) and bronchoalveolar lavage (BAL), in children with pulmonary tuberculosis.


METHODS
58 consecutive children with chest radiograph suggestive of tuberculosis and positive Mantoux test or a positive history of family contact with a case of tuberculosis were prospectively subjected to gastric lavage on three consecutive mornings and broncho-alveolar lavage on the last day. The samples were subjected to bacteriological isolation.


RESULTS
Samples from 10 (17.2%) children grew Mycobaterium tuberculosis from gastric lavage and 12 children had their BAL positive for this bacteria(p>0.05). Overall mycobacterial isolation was possible in 20 patients (34.4%) as two children had grown Mycobacterim tuberculosis in GL as well as BAL. Addition of BAL to the diagnostic work up increased the mycobacteriological yield from 17.2% with gastric lavage alone to 34.4% when BAL was also performed (p=0.013).


CONCLUSIONS
There is no difference in mycobacterial isolation rates from gastric lavage and BAL when studied in isolation. However, when both GL and BAL are used; these procedures complement each other to double the diagnostic yield.
Singh
M
M
Departments of Pediatrics and Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh 160 012, India.
Moosa
N V
NV
Kumar
L
L
Sharma
M
M
D000293:Adolescent; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D005260:Female; D005751:Gastric Lavage / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011336:Probability; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*