Bronchoscopy: A Modern Tool in the Diagnosis of Pulmonary Infections

Aim: To assess the significance of bronchoalveolar lavage and fibreoptic bronchoscopy in the early diagnosis of sputum smear negative pulmonary infections. Methods: This descriptive study was undertaken at the Department of Thoracic Surgery, King Edward Medical University/Mayo Hospital Lahore. A total of 115 patients of age 15 and above with clinical and/or radiological evidence of an infective pulmonary disease process and an inconclusive sputum smear were registered in this study. Chest radiographs were obtained in all of the cases. Flexible Bronchoscopy and Bronchoalveolar Lavage (BAL) were performed in all cases. Bronchial washings obtained from each patient were divided into two specimens. One was sent for ZN staining while the other was sent for gram staining and pyogenic culture and sensitivity. BAL findings were then noted in relation to radiological and bronchoscopic findings. Results: A total of 115 patients, 66 males and 49 females with clinical and/or radiological suspicion of a pulmonary infection and a negative sputum smear were subjected to Flexible Bronchoscopy during which Bronchoalveolar lavage was performed and Bronchial washings were taken. Each sample was divided into two specimens to look for AFB’s or pyogenic bacterial growths separately via stains and culture. Final results of BAL analysis revealed 41(35.7%) out of 115 samples to be positive for AFB’s, 41(35.7%) positive for pyogenic infections while 33(28.7%) samples exhibited no evidence of any bacterial growth. Conclusion: We suggest that physicians actively consider performing Bronchoscopy in sputum smear negative patients suspected of TB and other pulmonary infections.