Diagnostic role of fibreoptic bronchoscopy in tuberculosis in the presence of typical x-ray pictures and adequate sputum

Fibreoptic bronchoscopy (FOB) showed that of 82 patients who had ‘typical’ X-ray pictures of tuberculosis (fibronodular infiltrate in the upper lobe), 40 had active tuberculosis, 30 had inactive tuberculosis and 12 had non-specific fibrosis of undetermined origin. The remaining 16 patients with other specific aetiologies of the upper lobe lesions (e.g. carcinoma) had different X-ray pictures such as a mass or alveolar filling of lobar distribution. In communities with a high prevalence of tuberculosis FOB is therefore unlikely to reveal any specific aetiology (apart from tuberculosis) in immunologically competent patients who have ‘typical’ X-ray picture of tuberculosis.

We document, however, that in sputum-producing patients with active tuberculosis, FOB was the exclusive means of diagnosis in $\text{11}\text{27}$ (41 %), compared with $\text{10}\text{13}$ (77%) in nonsputum-producers. An immediate diagnosis was made in 22% and 38% of cases respectively.