Papel da fibrobroncoscopia no diagnostico de pacientes com suspeita de tuberculose pulmonar



Título del documento: Papel da fibrobroncoscopia no diagnostico de pacientes com suspeita de tuberculose pulmonar
Revista: Jornal brasileiro de pneumologia
Base de datos: PERIÓDICA
Número de sistema: 000297383
ISSN: 1806-3713
Autores: 1
2

Instituciones: 1Hospital Universitario Prof. Edgar Santos, Servico de Endoscopia Respiratoria, Salvador, Bahia. Brasil
2Hospital Sao Rafael, Salvador, Bahia. Brasil
Año:
Periodo: Ene-Feb
Volumen: 30
Número: 1
Paginación: 39-45
País: Brasil
Idioma: Portugués
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés BACKGROUND: Pulmonary tuberculosis is an infectious disease of high prevalence and incidence. The use of sputum bacilloscopy is a sure and speedy way of reaching a diagnosis. However as 30% to 50% of the bearers of pulmonary tuberculosis have a negative sputum smear or have no sputum the fiber bronchoscopy acquires a special importance. OBJECTIVES: To evaluate the sensitivity of the specimens collected by means of the fiber bronchoscopy (brochoalveolar lavage and transbronchial biopsy) for the diagnosis of patients suspected of having pulmonary tuberculosis, without confirmation by sputum bacilloscopy. METHOD: By review of the ledgers of fiber bronchoscopies carried out from March 1997 to March 2001, we identified and included in the study patients over 18 years of age and referred with suspicion of tuberculosis and at least three negative sputum smears. Data regarding age, gender, changes detected at thorax imaging and endoscopy were collected. RESULTS: Fifty-two patients with ages ranging from 19 to 77 years (median of 39), were included, 58% were of the male gender and 37% were patients from the Official Health System. Prevailing finding at chest X-ray was the alveolar infiltrate (80%). In 35 patients tuberculosis was the final diagnosis (one with associated neoplasia); in 28 patients (80%) diagnosis was achieved by bronchoscopy. Other diagnoses disclosed by bronchoscopy were neoplasias, histoplasmosis chronic eosinophil alvelolitis, pneumonia by Pneumocystis carinii and pulmonary fibrosis. CONCLUSION: results of this study point to the use of fiber bronchoscopy in patients suspect of tuberculosis, not diagnosed thorough sputum bacilloscopy, not only for pulmonary tuberculosis but also of those that represent differential diagnoses
Resumen en portugués Outros diagnósticos obtidos pela broncoscopia foram: neoplasia, histoplasmose, alveolite crônica eosinofilica, pneumonia por Pneumocystis carinii e fibrose pulmonar. CONCLUSÃO: Os resultados deste estudo indicam a realização da fibrobroncoscopia em pacientes com suspeita de tuberculose não confirmada através da baciloscopia do escarro para determinação diagnóstica, não só desta doença, como de todas as que representam diagnósticos diferenciais
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Neumología,
Tuberculosis pulmonar,
Broncoscopía
Keyword: Medicine,
Diagnosis,
Pneumology,
Pulmonary tuberculosis,
Bronchoscopy
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