Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;56(7):2186-2194.
doi: 10.1002/ppul.25405. Epub 2021 Apr 13.

Diagnostic utility of bronchoalveolar lavage in children with complicated intrathoracic tuberculosis

Pierre Goussard  1 , Roland Croucamp  2 , Corne Bosch  2 , Anne-Marie Demers  2 , Julie Morrison  1 , Lunga Mfingwana  1 , Megan Palmer  2 , Marieke M van der Zalm  2 , Sven O Friedrich  3 , Jacques T Janson  4 , Andrew C Whitelaw  5   6 , Savvas Andronikou  7 , Anneke C Hesseling  2 , Elisabetta Walters  2 , Elisa Lopez-Varela  2   8
Affiliations

Diagnostic utility of bronchoalveolar lavage in children with complicated intrathoracic tuberculosis

Pierre Goussard et al. Pediatr Pulmonol. 2021 Jul.

Abstract

Introduction: Bronchoscopy can be a useful tool in children with pulmonary tuberculosis (PTB) with severe disease potentially requiring intervention or in the face of diagnostic dilemmas. The aim of this study was to determine the value of Xpert MTB/RIF assay (Xpert) on bronchoalveolar lavage (BAL) samples in children with complicated PTB.

Methods: Retrospective analysis of children with clinically diagnosed PTB, who underwent routine bronchoscopy over a 5-year period at a large referral hospital. BAL and other respiratory samples were tested by microscopy, culture, and Xpert. We explored whether clinical, radiographic and bronchoscopy findings, and duration of antituberculosis treatment were associated with bacteriological confirmation.

Results: One hundred and twelve out of one hundred and forty-six (76.7%) children (median age 16 months) were on antituberculosis treatment for a median of 10 days at the time of bronchoscopy. Overall, bacteriological confirmation was achieved in 115 (78.7%), with 101 (69.2%) detected on BAL. Of those bacteriologically confirmed on BAL, 61.4% were positive by both Xpert and culture, 34.7% only by Xpert, and 3.9% only by culture. Sensitivity and specificity of Xpert compared with culture on BAL samples for children not on antituberculosis treatment were 94.1% (95% confidence interval [CI]: 71.3, 99.8) and 68.7% (95% CI: 41.3, 89.0), respectively.

Conclusions: In children undergoing bronchoscopy for complicated PTB, Xpert testing of BAL had a high diagnostic yield in children already on antituberculosis treatment. Bronchoscopy should be considered if noninvasive respiratory specimens fail to confirm complicated TB.

Keywords: GeneXpert MTB/RIF; bronchoalveolar lavage; bronchoscopy; pulmonary tuberculosis.

PubMed Disclaimer

References

REFERENCES

    1. Dodd PJ , Gardiner E , Coghlan R , Seddon JA . Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health. 2014;2(8):e453-e459. http://www.ncbi.nlm.nih.gov/pubmed/25103518
    1. World Health Organization. Global Tuberculosis Report 2019. Geneva: WHO; 2020.
    1. Jenkins HE , Yuen CM , Rodriguez CA , et al. Mortality in children diagnosed with tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis. 2017;17(3):285-295.
    1. Seddon JA , Jenkins HE , Liu L , et al. Counting children with tuberculosis: why numbers matter. Int J Tuberc Lung Dis. 2015;19(Suppl 1 01):9-16. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4708268&to...
    1. Perez-Velez CM , Marais BJ . Tuberculosis in children. N Engl J Med. 2012;367(4):348-361. http://www.nejm.org/doi/abs/10.1056/NEJMra1008049

Publication types

LinkOut - more resources