Oğuzhan OKUTAN, Zafer KARTALOĞLU, Erkan BOZKANAT, Faruk ÇİFTÇİ, Ahmet İLVAN

Radyolojik olarak akciğer tüberkülozu düşünülen balgam çıkaramayan ve mide suyu yayması negatif olan hastalarda bronş lavajının değeri

Radyolojik olarak akciğer tüberküloz (Tbc)'u düşünülen ve mide suyu yayması negatif olan hastalarda bronş lavajında asidorezistan basil (ARB) araştırılmasının tanıya katkısını değerlendirdik. Çalışmaya 83 hasta alındı, ancak beş olgu inaktif hastalık veya Tbc dışı hastalık olarak değerlendirildiği için çalışmadan çıkarıldı. Kalan 78 hasta incelendi. Hastaların hiçbiri balgam çıkaramıyordu ve mide suyu yayması negatif idi. Çalışma sonunda, 12 (%15.4) hastada bronş lavajı yayması pozitif idi. Bronş lavajı kültürü 42 (%53.8) hastada, mide suyu kültürü 26 (%33.3) hastada pozitif olarak saptandı. Onsekiz hastada hem mide suyu hem de bronş lavajı kültürü pozitif idi. Mide suyu kültürü negatif olan 24 hastada bronş lavajı kültürü pozitif olarak bulundu. Sonuç olarak; balgam çıkaramayan ve mide suyu yayması negatif olan olgularda akciğer Tbc'si tanısını koymak için bronş lavajı incelemesi yapılmalıdır.

The value of bronchial lavage in patients with radiologically suggestive pulmonary tuberculosis with no sputum production and gastric lavage smear negativity

We assessed whether acid-fast bacilli (AFB) investigation in bronchial lavage (BL) contributes to diagnosis in patients with gastric lauage smear negative and radiologically suggestive of pulmonary tuberculosis. Eighty-three patients were recruited for the study, fiue cases were excluded due to diagnosis of inactiue disease or non-tuberculosls disease. The remaining 78 patients were eualuated. All patients were unable to expectorate sputum and their gastric lauages were negatiue for AFB. BL was performed for the detection of Mycobacterium tuberculosis in all patients. Bronchial lavage smear were positive in 15.4%(12 patients). BL culture positivity was 58.3%(42 patients) and gastric lauage culture positivity was 33.3%(26 patients). Eighteen cases had both gastric lavage and BL culture positivity. BL culture was posive in 24 cases who had gastric lavage culture negativity. We suggest that in cases who do not produce sputum and whose gastric lavage smears are negative; BL should be performed for diagnosis of pulmonary tuberculosis.

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