Diagnosis of Pulmonary Tuberculosis by Gastric Aspirate in Adults Who are Smear Negative and X Ray Positive Suspects of Pulmonary Tuberculosis and Additional Yield by Fiberoptic Bronchoscopy

Tuberculosis is an age old infection caused by Mycobacterium Tuberculosis complex. Early diagnosis of Pulmonary Tuberculosis is very important in treatment and decreasing the transmission of tuberculosis. It is difficult to obtain sample in children and in adults especially in cases of females. Adequate sample can be obtained by various methods such as laryngeal swabs, BAL, sputum. Gastric aspiration is established method in children but in adults it is usually not tried. Some adults especially females instead of expectorating swallow their sputum. In this study, we have evaluated diagnostic yield of gastric aspirate and additional yield by bronchoscopy in smear negative and x ray positive suspects of tuberculosis . Objective- To see the yield by gastric aspiration and additional yield on bronchoscopy in smear negative x ray positive suspects of TB cases Material and method-Present study was conducted in 200 smear negative X ray suspects. Initially gastric aspiration was done, those still found negative , bronchoscopy was done and specimen for brush, Bal, Biopsy taken and examined by ZN staining, CBNAAT and culture for Mycobacterium tuberculosis . Results- It was found Out of 200 X-ray suspected patients gastric aspirate was found positive for TB in 30 (15%) (smear AFB/CBNAAT) of the patients. Out of 170 gastric aspirates negative TB patient’s bronchoscopy could be carried out in 50 patients only despite of counselling. Additional yield of 14.7% was observed with bronchoscopy Conclusion- The present study concludes that in smear negative X ray positive suspects of TB patients, gastric aspiration can be initial tool which can be applied in peripheral institutions and bronchoscopy can provide additional yield in high center