Fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis--a Malaysian experience

We report our experience on the use of fibreoptic bronchoscopy in the diagnosis of pulmonary tuberculosis. The case records of 1,274 patients who underwent fibreoptic bronchoscopy at the National Tuberculosis Centre, Kuala Lumpur, Malaysia during a three-year period were reviewed. In 120 of them the final diagnosis was tuberculosis. Bronchoscopy confirmed the diagnosis in 37 patients (30.8%). This was achieved by bronchial aspiration for culture in 26 patients (70.3%) and bronchial biopsy for histopathology in 11 patients (29.7%). It was the exclusive method of confirmation in 16 patients (13.3%). Sputum culture was positive in 62 patients (51.7%) including 41 patients (34.2%) in whom bronchoscopy was unhelpful. Six patients had diagnosis confirmed by other means while in 36 others (30%) it was based on clinical features and supportive basic investigations. There were no complications noted. We conclude that while sputum examination remains the mainstay for diagnosing pulmonary tuberculosis, fibreoptic bronchoscopy serves as a safe and useful adjunct.