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Fiberoptic bronchoscopy for the rapid diagnosis of smear-negative pulmonary tuberculosis.

Authors
 Jung Ar Shin  ;  Yoon Soo Chang  ;  Tae Hoon Kim  ;  Hyung Jung Kim  ;  Chul Min Ahn  ;  Min Kwang Byun 
Citation
 BMC Infectious Diseases, Vol.12 : 141, 2012 
Journal Title
 BMC Infectious Diseases 
ISSN
 1471-2334 
Issue Date
2012
MeSH
Adult ; Aged ; Bronchoscopy/methods* ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Radiography, Thoracic ; Republic of Korea ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary/diagnosis*
Keywords
Positive Predictive Value ; Negative Predictive Value ; Tuberculin Skin Test ; Rapid Diagnosis ; HRCT Finding
Abstract
BACKGROUND: This study was aimed to investigate the diagnostic value of fiberoptic bronchoscopy (FOB) with chest high-resolution computed tomography (HRCT) for the rapid diagnosis of active pulmonary tuberculosis (PTB) in patients suspected of PTB but found to have a negative sputum acid-fast bacilli (AFB) smear. METHODS: We evaluated the diagnostic accuracy of results from FOB and HRCT in 126 patients at Gangnam Severance Hospital (Seoul, Korea) who were suspected of having PTB. RESULTS: Of 126 patients who had negative sputum AFB smears but were suspected of having PTB, 54 patients were confirmed as having active PTB. Hemoptysis was negatively correlated with active PTB. Tree-in-bud appearance on HRCT was significantly associated with active PTB. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FOB alone was 75.9%, 97.2%, 95.3%, and 84.3%, respectively, for the rapid diagnosis of active PTB. The combination of FOB and HRCT improved the sensitivity to 96.3% and the NPV to 96.2%. CONCLUSIONS: FOB is a useful tool in the rapid diagnosis of active PTB with a high sensitivity, specificity, PPV and NPV in sputum smear-negative PTB-suspected patients. HRCT improves the sensitivity of FOB when used in combination with FOB in sputum smear-negative patients suspected of having PTB.
Files in This Item:
T201203945.pdf Download
DOI
22726571
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Kim, Hyung Jung(김형중) ORCID logo https://orcid.org/0000-0003-2498-0683
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Shin, Jung Ar(신정아)
Ahn, Chul Min(안철민)
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89785
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