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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Published in:BMC infectious diseases Vol. 25; no. 1; pp. 680 - 6
Main Authors: 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
Language:English
Published: London BioMed Central 08.05.2025
BioMed Central Ltd
Springer Nature B.V
BMC
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ISSN:1471-2334, 1471-2334
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Summary: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.
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ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-025-11020-3