Clinical Utility of CT-Based Bronchial Aspirate TB-PCR for the Rapid Diagnosis of Pleural Tuberculosis / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
; : 150-156, 2013.
Article
in En
| WPRIM
| ID: wpr-48225
Responsible library:
WPRO
ABSTRACT
BACKGROUND: Thoracoscopic pleural biopsy is often required for rapid and confirmative diagnosis in patients with suspected pleural tuberculosis (PL-TB). However, this method is more invasive and costly than its alternatives. Therefore, we evaluated the clinical utility of the chest computed tomography (CT)-based bronchial aspirate (BA) TB-polymerase chain reaction (PCR) test in such patients. METHODS: Bronchoscopic evaluation was performed in 54 patients with presumptive PL-TB through diagnostic thoracentesis but without a positive result of sputum acid-fast bacilli (AFB) smear, pleural fluid AFB smear, or pleural fluid TB-PCR test. Diagnostic yields of BA were evaluated according to the characteristics of parenchymal lesions on chest CT. RESULTS: Chest radiograph and CT revealed parenchymal lesions in 25 (46%) and 40 (74%) of 54 patients, respectively. In cases with an absence of parenchymal lesions on chest CT, the bronchoscopic approach had no diagnostic benefit. BA TB-PCR test was positive in 21 out of 22 (95%) patients with early-positive results. Among BA results from 20 (37%) patients with patchy consolidative CT findings, eight (40%) were AFB smear-positive, 18 (90%) were TB-PCR-positive, and 19 (95%) were culture-positive. CONCLUSION: The BA TB-PCR test seems to be a satisfactory diagnostic modality in patients with suspected PL-TB and patchy consolidative CT findings. For rapid and confirmative diagnosis in these patients, the bronchoscopic approach with TB-PCR may be preferable to the thoracoscopy.
Key words
Full text:
1
Database:
WPRIM
Main subject:
Sputum
/
Thoracoscopy
/
Thorax
/
Tuberculosis, Pleural
/
Biopsy
/
Bronchoscopy
/
Polymerase Chain Reaction
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Tuberculosis and Respiratory Diseases
Year:
2013
Document type:
Article