title: Bronchoscopy in immediate diagnosis of smear negative tuberculosis.
abstract: BACKGROUND
  Tuberculosis is a major public health problem. Almost 30% of cases of tuberculosis are known to be sputum smear negative. There is a diagnostic dilemma in such cases leading to inadvertent delays in management of these cases. The present study was planned to assess the role of bronchoscopy in immediate diagnosis of smear negative pulmonary tuberculosis.
  
  
  METHODS
  The present study is a retrospective analysis of 132 sputum smear negative tuberculosis suspects who underwent bronchoscopic evaluation during the period 2002-2013. The diagnosis of tuberculosis was based on the finding of bacilli in aspirate or in tissue biopsy or the demonstration of caseous necrosis on tissue biopsy.
  
  
  RESULTS
  The present study showed that bronchoscopy could lead to immediate, accurate diagnosis in 68.2% of suspected smear negative cases. Bronchial aspirate and bronchoalveolar lavage alone were diagnostic in 51.5% of such cases while tissue biopsy added to the yield in another 16.5% cases.
  
  
  CONCLUSIONS
  The results of the present study suggests an important place of bronchoscopy in immediate diagnosis of suspected smear negative tuberculosis, thus avoiding inadvertent delays in diagnosing and instituting appropriate treatment.
authors.affiliation: Department of Respiratory Allergy and Applied Immunology, National Centre of Respiratory Allergy, Asthma and Immunology, Delhi, India. rajkumarvpci@gmail.com.
authors.forename: Raj
authors.initials: R
authors.lastname: Kumar
authors.forename: Mandeep
authors.initials: M
authors.lastname: Singh
authors.forename: Nitesh
authors.initials: N
authors.lastname: Gupta
authors.forename: Nitin
authors.initials: N
authors.lastname: Goel
mesh_terms: D018893:Bronchoalveolar Lavage / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D001999:Bronchoscopy / Q000379:methods*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology