title: The Value of Bronchoalveolar Lavage in the Diagnosis of Sputum Smear-NegativePulmonary Tuberculosis.
abstract: OBJECTIVE
  Sputum smear staining for acid-fast bacilli is initial approach to the diagnosis of pulmonary tuberculosis (PTB) but more than 50% of cases are sputum smear-negative. This study was aimed to investigate the diagnostic value of fiberoptic bronchoscopy (FOB) guided bronchoalveolar lavage (BAL) in patients suspected to have tuberculosis.
  
  
  METHODS
  This prospective cross-sectional study was carried out on 290 sputum smear-negative patients who were clinically suspicious for PTB in 2006-12. All patients were subjected to FOB andBAL, then BAL specimens stained and cultured.
  
  
  RESULTS
  Of the 290 patients, 173 cases (59.7%) were men and 117 cases (40.3%) were women with the age of 52.6±19.1 years (ranged 20-76 years). Of the total 290 BAL specimens, 110 specimens (38%) were positive for acid-fast bacilli. Sensitivity, specificity, PPV and NPV was 60%, 91%, 89% and 64%, respectively. Also, LR (+) and LR (-) was 64.6% and 0.44%, respectively.
  
  
  CONCLUSIONS
  FOB guided BAL is a reliable, rapid and useful method for establishing the diagnosis of smear negative PTB with minimal complications.
authors.affiliation: Dept. of Surgery, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Novin
authors.initials: N
authors.lastname: Nikbakhsh
authors.affiliation: Infectious and Tropical Disease Research Center, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Masomeh
authors.initials: M
authors.lastname: Bayani
authors.affiliation: Dept. of Pathology, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Siadati
keywords: Bronchoalveolar Lavage; Pulmonary Tuberculosis; Sputum