Bronchoalveolar Lavage is Useful for the Diagnosis of Pulmonary Tuberculosis in Children

Objective: To compare the mycobacteriological yield from self-expectorated sputum (SP), gastric lavage (GL) and bronchoalveolar lavage (BAL), in children with pulmonary tuberculosis (TB). Methods: Twelve children with cultureor PCR-positive pulmonary TB were retrospectively enrolled in this study. These patients had undergone SP collection, GL and/or BAL through flexible bronchoscopy. Positive culture yield rates from these three methods were compared. Results: The positive bacterial yield from BAL (85.7%; six of seven patients) was significantly higher than specimens from SP (75.0%; six of eight patients) and GL (60.0%; six of ten patients). Combining BAL and SP or BAL and GL increased culture positivity to 100% (10 of 10 patients, and seven of seven patients, respectively). Conclusion: Flexible bronchoscopy with BAL is a useful diagnostic modality for diagnosis of pulmonary TB in children. When combinations of BAL and SP or BAL and GL are used, a higher rate of diagnosis of pulmonary TB can be achieved. Flexible bronchoscopy with BAL and GL can be used for patients who cannot expectorate, or for patients whose sputum is smear negative for acid-fast bacilli (AFB). (J Pediatr Resp Dis 2015;11:35-39)