Role of Induced Sputum and Bronchoalveolar Lavage in Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis

Dr. Robin Varughese John, Dr. Hafiz Deshmukh, Dr. Rutuja Prabhudesai, Dr. Shivprasad Kasat, Dr. Ashish Deshmukh, Dr. Sunil Jadhav

Abstract: Introduction: Tuberculosis is an illness of antiquity which is caused by acid fast bacillus, Mycobacterium tuberculosis. It affects mainly the lungs however can likewise affect other organs in the body. Transmission usually takes place through air borne spread of droplet nuclei from patients of known cases of pulmonary tuberculosis. Present study was conducted to determine the diagnostic yield of induced sputum and bronchoalveolar lavage in diagnosis of sputum smear negative pulmonary tuberculosis. Materials and Method: The present study is a Non-Randomized Prospective Cross-Sectional study from October 2019 to September 2021. Patients with clinical suspicion of pulmonary tuberculosis were selected from OPD (Outpatient Department) and admitted to IPD (Inpatient department). Clinical specimens were submitted to the microbiology laboratory of MGM Medical College and Hospital Aurangabad. Results: A total of 36 patients were selected in the study, a majority of the cases i. e.12 (33.33%) were in age group of 21-30 years. BAL AFB was positive in 20 patients giving a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for BAL AFB were 86.96%, 100%, 100%, 81.25% and 91.67% respectively. Out of 23 cases that were positive for BAL for CBNAAT, only 10 cases were positive on induced sputum for CBNAAT, which is a concordance of 43.47%. All 13 negative cases on BAL for CBNAAT and for AFB were detected negative on induced sputum too with a concordance of 100%. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for BAL CBNAAT was 90%, 100.00%, 100.00%, 96.30% and 97.22% respectively. Conclusion: For diagnosis of pulmonary tuberculosis, a adequate sputum sample is one of the most important requirement. In patient?s that fail to produce such a sample, induction of sputum, is a cheap, safe, reliable procedure with greater patient comfort, no age restriction and less time consuming. It should be carried out in patients as an initial procedure prior to advising and subjecting them to invasive diagnostic procedures like bronchoscopy.

Keywords: pulmonary tuberculosis, sputum sample, bronchoscopy, bronchoalveolar lavage, AFB, CBNAAT

How to Cite?: Dr. Robin Varughese John, Dr. Hafiz Deshmukh, Dr. Rutuja Prabhudesai, Dr. Shivprasad Kasat, Dr. Ashish Deshmukh, Dr. Sunil Jadhav, "Role of Induced Sputum and Bronchoalveolar Lavage in Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis", Volume 14 Issue 7, July 2025, International Journal of Science and Research (IJSR), Pages: 1075-1082, https://www.ijsr.net/getabstract.php?paperid=SR25716134102, DOI: https://dx.doi.org/10.21275/SR25716134102