Diagnosis of Pulmonary Tuberculosis in less Sputum Producing or Sputum Smear Negative Cases: A Prospective Study in a Tertiary Care Hospital

  • Chandra Shekhar Purohit Assistant Professor, Pulmonary Medicine, SRMSIMS, Bhojpura, Bareilly.
Keywords: Pulmonary tuberculosis, mortality, Sputum induction, sensitivity

Abstract

Background: To Diagnosis of Pulmonary Tuberculosis in less Sputum Producing or Sputum Smear Negative Cases. Methods: 200 patients were included in this study with either no sputum or inadequate sputum (only saliva or sputum quantity < 2 ml) or whose initial two sputum smear examinations for AFB were negative, were included in the study.

Results: Sputum induction was successful in 96% of patients who could produce adequate volume (> 2 ml). 4 males and 4 female patients having dry cough were unable to produce sputum even after induction. Overall, 47% of patients were found positive on smear examination after sputum induction. 68 patients out of 136 (50%), who were having sputum and were negative on routine smear examination, were found positive on induced sputum smear examination. Sputum induction was successful in confirmation of diagnosis in 40.62% (26/64) of patients who were having cough with no/inadequate sputum.

Conclusion: This study revealed that this method useful and also enhance the sensitivity for diagnosis of tuberculosis.

Background: To Diagnosis of Pulmonary Tuberculosis in less Sputum Producing or Sputum Smear Negative Cases. Methods: 200 patients were included in this study with either no sputum or inadequate sputum (only saliva or sputum quantity < 2 ml) or whose initial two sputum smear examinations for AFB were negative, were included in the study.

Results: Sputum induction was successful in 96% of patients who could produce adequate volume (> 2 ml). 4 males and 4 female patients having dry cough were unable to produce sputum even after induction. Overall, 47% of patients were found positive on smear examination after sputum induction. 68 patients out of 136 (50%), who were having sputum and were negative on routine smear examination, were found positive on induced sputum smear examination. Sputum induction was successful in confirmation of diagnosis in 40.62% (26/64) of patients who were having cough with no/inadequate sputum.

Conclusion: This study revealed that this method useful and also enhance the sensitivity for diagnosis of tuberculosis.

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References

1. WHO Global tuberculosis report; 2016. Available at- http://www.who.int>tb>global_report.
2. TB India; 2012. Available form: Annual status report/tbcindia. nic.in/pdfs/Tbndia2012annualreport. Available at http://tbcindia.nic.in.
3. Kochi A. The global tuberculosis situation and the new control strategy of the World Health Organization Tubercl. 1991;72:1-6.
4. World Health Organization. Treatment of tuberculosis: guidelines for national programs. Geneva: World Health Organization; 1993.
5. Swai HF, Mugusi FM, Mbwambo JK. Sputum smear negative pulmonary TB: Sensitivity and Specificity of diagnostic algorithm. BMC Res Notes. 2011;4:475.
6. Cattamanchi A, Dowdy DW, Davis JL, Worodria W, Yoo S, Joloba M, et al. Sensitivity of direct versus concentrated sputum smear microscopy in HIV-infected patients suspected of having pulmonary tuberculosis. BMC Infect Dis. 2009;9: 53.
7. Foulds J, O’Brien R. New tools for the diagnosis of tuberculosis; the perspective of developing countries. Int J tuberc Lung Dis. 1998;2:778-83.
8. Ramachandran V, Pachamuthu B, Esaki SM, Kailapuri MG, Settu H, Anitha CJ, et al. Value of single acid-fast bacilli sputum smears in the diagnosis of tuberculosis in HIV-positive subjects. J Med Microbiol. 2007;56:1709-10.
9. Hong Kong Chest service/tuberculosis research center, Madras/ British Research Council. A study of the character and course of sputum smear negative pulmonary tuberculosis. Tubercle. 1981; 62:155-67.
10. Mohan A, Pande JN, Sharma SK, Rattan A, Guleria R, Khilnani GC. Bronchoalveolar lavage in pulmonary tuberculosis: a decision analysis approach. Q J Med. 1995;88:269-76. 11. Robinson B. Policy, Protocols and Procedures for Sputum Induction for Diagnosis of Respiratory Infections. John Hunter Hospital; 1997.
11. Gupta KB, Garg S. Use of sputum induction for establishing diagnosis in suspected pulmonary tuberculosi. Indian J Tuberc. 2005;52:143-6.
12. Gonzalez-Angulo Y, Wiysonge CS, Geldenhuys H, Hanekom W, Mahomed H, Hussey G, et al. Sputum induction for the diagnosis of pulmonary tuberculosis: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis. 2012;31(7):1619- 30.
13. Li LM, Bai LQ, Yang HL, Xiao CF, Tang RY, Cheu YF, et al. Sputum induction to improve diagnostic yield in patients with suspected pulmonary tuberculosis. Int J Tubercle Lung Dis. 1999;3(2): 1137-9.
14. Conde MB, Soares SL, Mello FC, Rezende Vm, Almeida LL, Reingold AL, et al. Comparison of sputum induction with fiberoptic bronchoscopy in the diagnosis of tuberculosis: experience at an acquired immune deficiency syndrome reference centre in Rio de Janeiro, Brazil. Am J Respir Crit Care Med. 2000;162: 2238-40.
15. Menzies D. Sputum induction: Simpler, cheaper, and safer- but is it better? Am J Respir Crit Care Med 2003;167:676-7.
16. Gupta KB, Garg S. Use of sputum induction for establishing diagnosis in suspected pulmonary tuberculosi. Indian J tuberc. 2005;52:143-6.
17. Atiq-ur-Rehman M, Naseem A, Hussain T. Comparison of Diagnostic Yield of AFB with Sputum Induction to Spontaneous Sputum Examination in Suspected Pulmonary Tuberculosis. J Coll Physicians Surg Pak. 2009;19(8):506-9.
18. Biswas S, Das A, Sinha A, Das SK, Bairagya TD. The role of induced sputum in the diagnosis of pulmonary tuberculosis. Lung India. 2013;3093: 199-202.
Published
2018-06-29
How to Cite
1.
Purohit C. Diagnosis of Pulmonary Tuberculosis in less Sputum Producing or Sputum Smear Negative Cases: A Prospective Study in a Tertiary Care Hospital. IABCR [Internet]. 29Jun.2018 [cited 22Jul.2018];4(2):76-9. Available from: https://iabcr.org/index.php/iabcr/article/view/344