Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis

Aim of this study was to compare the diagnostic yield of induced sputum (IS) and bronchoalveolar lavage (BAL) in patients with suspected pulmonary tuberculosis (PTB) and negative sputum smears. We enrolled 215 patients who underwent both IS and BAL after two negative spontaneous sputum samples. PTB...

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Veröffentlicht in:BMC infectious diseases Jg. 25; H. 1; S. 680 - 6
Hauptverfasser: Musso, Maria, Gualano, Gina, Mencarini, Paola, Mastrobattista, Annelisa, Licata, Maria Angela, Pareo, Carlo, Cerva, Carlotta, Mosti, Silvia, Di Bari, Virginia, Libertone, Raffaella, Nisii, Carla, Cannas, Angela, Navarra, Assunta, Goletti, Delia, Palmieri, Fabrizio
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 08.05.2025
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Adult
Aged
Alveoli
Analysis
Bronchoalveolar lavage
Bronchoalveolar Lavage - methods
Bronchoalveolar Lavage Fluid - microbiology
Bronchoscopy
Bronchus
Care and treatment
Consents
Demographic aspects
Diagnosis
Endoscopy
Female
Humans
Infectious Diseases
Internal Medicine
Lavage
Male
Medical Microbiology
Medicine
Medicine & Public Health
Microscopy
Middle Aged
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - isolation & purification
Parasitology
Patients
Pulmonary tuberculosis
Resource availability
Sensitivity analysis
Sensitivity and Specificity
Sputum
Sputum - microbiology
Tropical Medicine
Tuberculosis
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - microbiology
Variables
Young Adult
Italy
United States > US
ISSN:1471-2334, 1471-2334
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Zusammenfassung:Aim of this study was to compare the diagnostic yield of induced sputum (IS) and bronchoalveolar lavage (BAL) in patients with suspected pulmonary tuberculosis (PTB) and negative sputum smears. We enrolled 215 patients who underwent both IS and BAL after two negative spontaneous sputum samples. PTB was confirmed by culture or molecular test in 26 patients (12.1%). IS detected 10 cases (38.5%) of all PTB, while BAL detected 22 cases (84.6%) of all PTB. IS had a sensitivity of 38.46% and a specificity of 100%, while BAL had a sensitivity of 84.62% and a specificity of 100%. BAL had a higher diagnostic yield than IS and was useful for ruling out alternative diagnoses. According to our experience FBS execution is mandatory in case of strong TB suspicion and sputum smear negative patients, especially in a low TB prevalence country. Moreover, it consents testing microorganism sensitivity and assessing possible alternative diagnosis with similar clinical presentation. The choice of the best diagnostic method may depend on the clinical context and the availability of resources. Highlights The study compared IS and BAL in suspected PTB patients with negative sputum smears. BAL had a higher diagnostic yield than IS and detected 84.6% of all PTB cases. BAL was also useful for ruling out alternative diagnoses. FBS execution is mandatory in case of strong TB suspicion and sputum smear negative patients, especially in a low TB prevalence country. The choice of the best diagnostic method may depend on the clinical context and the availability of resources.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-025-11020-3