Downloads
Abstract
Background: Tuberculosis is an infectious disease, a major cause of illness and one of the leading causes of death worldwide. The diagnosis of AFB - negative pulmonary TB remains a medical challenge.
Methods: Retrospective study All patients with clinical symptoms and chest X-ray suspected of pulmonary tuberculosis admitted to the Department of Pulmonary Diseases - Hue Central Hospital, from January to December 2022, tested 2 negative sputum AFB and negative sputum Xpert MTB/RIF calculated and indicated bronchoscopy.
Results: Among 47 patients who were eligible for the study, there were 31 (66.0%) lesions on bronchoscopy, no lesions 16 (34.0%), the difference was statistically significant with p = 0.0287. The most common lesion feature was edematous - hyperemic in 20 patients (64.5%). fibrostenotic and sputum met with the rate of 8 (25.8%) and 7 (22.6%). The most common location of lesions on the right was 16 (51.6%). The positive rate of Xpert MTB/RIF test in bronchoalveolar lavage was 36.2%.
Conclusion: Bronchoscopy is a useful tool in diagnosing pulmonary tuberculosis through imaging and especially in obtaining fluid for testing. Xpert MTB/RIF test in bronchoalveolar lavage is of high value in diagnosing difficult cases of pulmonary tuberculosis.
References
World health Organization. Global Tuberculosis Report. 2022.
Bộ Y tế.Chương trình Chống lao Quốc gia, Đường lối
Chương trình Chống lao Quốc gia Việt Nam. Hướng dẫn
quản lý bệnh lao. 2020, Hà Nội: Nhà xuất bản Y học.
Bộ Y tế, Quyết định về việc ban hành Hướng dẫn chẩn đoán,
điều trị và dự phòng bệnh lao Số: 1314/QĐ-BYT. 2020.
Trần Hùng. Lao phổi. Bài giảng Bệnh học lao. 2019:
Trường Đại học Y Dược Huế.
Sanjeevaiah S, Haranal MY, Buggi S. Role of flexible
bronchoscopy in patients with sputum - negative
pulmonary tuberculosis. Indian J Thorac Cardiovasc Surg.
;34(3):365-369.
Lê Hoàn. Nhận xét kết quả của xét nghiệm gene Xpert MTB/
RIF đờm trong chẩn đoán lao phổi tại Bệnh viện Đại học Y
Hà Nội. Tạp chí Nghiên cứu y học. 2021;147(11):23-29.
Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta
V, Khalid S, et al. British Thoracic Society guideline for
diagnostic flexible bronchoscopy in adults: accredited by
NICE. Thorax. 2013;68 Suppl 1i1-i44.
Phan Thu Phương, Mai Thanh Tú. Đặc điểm lâm sàng, cận
lâm sàng và kết quả GeneXpert trong dịch rửa phế quản phế
nang cua bệnh nhân nghi lao phổi, Trường Đại học Y Hà
Nội, Hà Nội. Tạp chí Y học Việt Nam. 2015;2172-178.
Chung HS, Lee JH. Bronchoscopic assessment of the
evolution of endobronchial tuberculosis. Chest. 2000;
(2):385-92.
World health Organization, Rapid implementation of the
Xpert MTB/RIF diagnositic test, Switzerland. 2011.
Mohd Esa NY, Othman SK, Mohd Zim MA, Tengku Ismail
TS, Ismail AI. Bronchoscopic Features and Morphology of
Endobronchial Tuberculosis: A Malaysian Tertiary Hospital
Experience. J Clin Med. 2022;11(3).
Lee JH, Park SS, Lee DH, Shin DH, Yang SC, Yoo BM.
Endobronchial tuberculosis. Clinical and bronchoscopic
features in 121 cases. Chest. 1992;102(4):990-4.
Gowda NC, Ray A, Soneja M, Khanna A, Sinha S.
Evaluation of Xpert ((R)) Mycobacterium tuberculosis/
rifampin in sputum - smear negative and sputum - scarce
patients with pulmonary tuberculosis using bronchoalveolar
lavage fluid. Lung India. 2018;35(4):295-300.
Lee HY, Seong MW, Park SS, Hwang SS, Lee J, Park YS, et al.
Diagnostic accuracy of Xpert(R) MTB/RIF on bronchoscopy
specimens in patients with suspected pulmonary tuberculosis.
Int J Tuberc Lung Dis. 2013; 17(7):917-21.
Le Palud P, Cattoir V, Malbruny B, Magnier R, Campbell
K, Oulkhouir Y, et al. Retrospective observational study of
diagnostic accuracy of the Xpert (R) MTB/RIF assay on
fiberoptic bronchoscopy sampling for early diagnosis of
smear - negative or sputum - scarce patients with suspected
tuberculosis. BMC Pulm Med. 2014;14137.
| Published | 20-08-2023 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | No. 89 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.89.19 | |
| Keywords | Lao phổi, AFB đàm âm tính, Nội soi phế quản. Tuberculosis. AFB - Sputum negative. Bronchoscopy |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2023 Journal of Clinical Medicine Hue Central Hospital