A prospective assessment of the role of bronchoscopy and bronchoalveolar lavage in evaluation of children with pulmonary tuberculosis.

OBJECTIVE To assess the diagnostic yield of fibreoptic bronchoscopy and bronchoalveolar lavage (BAL) compared to gastric aspiration (GA) in children with probable pulmonary tuberculosis (TB). METHODS Children with probable pulmonary TB were subjected to bronchoscopy, BAL and gastric aspiration. The samples were examined for acid fast bacilli (AFB) on smear. RESULTS A total of 52 children underwent bronchoscopy with BAL and GA. AFB on smear was identified in 19 (36.5%); BAL was positive in 16 (30.8%) and GA was positive in 11 (21.15%). GA alone was positive in 3 (5.67%) while BAL alone was positive in 8 (15.38%). Bronchoscopy detected airways' abnormality in 29 (56%) of patients. One GA and BAL detected AFB in majority of patients. CONCLUSION The diagnostic yield for AFB from BAL was better than that from GA in children with probable pulmonary TB. Combining one GA and bronchoscopy may improve AFB yield in children with pulmonary TB.