Author/Editor		Triller, Nadja; Debeljak, Andrej; Kecelj, Peter; Eržen, Damjan; Osolnik, Katarina; Kern, Izidor; Žolnir-Dovč, Manca; Šorli, Jurij
Title		Bronhoskopska diagnostika pljučne tuberkuloze
Translated title		Diagnosis of pulmonary tuberculosis by flexible fiberoptic bronchoscopy
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 6
Publication year		2000
Volume		str. 435-7
Language		slo
Abstract		Background. When tuberculosis is clinically suspected, bronchoscopy is indicated in patients after three or more negative sputum smears. Methods. From April to December 1998 we examined 50 patients with clinical suspicion of active TB with three or more negative sputum smears. Samples for cytology, histology and bacteriology were taken by routine techniques (bronchial biopsy, bronchoscopic lung biopsy, washing, brushing and bronchoscopic needle aspiration). We also examined sputum immediately after bronchoscopy. We used standard bacteriological methods (microscopic examination, isolation of mycobacteria by culture and amplification testing). Results. We examined 50 patients (35 males and 15 females, age 50.5 +-15.1 yr.) and confirmed active diseases in 11 (22%) of them. Positive bacteriological samples were bronchial washings (73%), brushings (45%), bronchoscopic lung biopsies (36%) and sputum after bronchoscopy (45%). Conclusion. In sputum smear negative patients we confirmed that bronchoscopy could provide adequate samples for bacteriological and/or histological confirmation of active tuberculosis.
Summary		Izhodišča. Bronhoskopska diagnostika pljučne tuberkuloze je indicirana pri bolnikih, pri katerih je bolezen glede na klinično sliko verjetna, s pregledom najmanj treh jutranjih izmečkov pa bacilov tuberkuloze ne dokažemo. Metode. Od aprila do decembra 1998 smo bronhoskopirali 50 bolnikov, pri katerih je bila pljučna tuberkuloza glede na klinično sliko in rentgenološke spremembe zelo verjetna, trije zaporedni jutranji izmečki pa so bili bakteriološko negativni. Ob bronhoskopiji smo bronhe izpirali, krtačili, opravili pljučno biopsijo ter aspiracijsko biopsijo bezgavk mediastinuma, bolniki so oddali izmeček po bronhoskopiji. Kužnine smo pregledali s klasičnimi bakteriološkimi metodami (mikroskopski pregled s fluorescenčno metodo ter osamitev mikrobakterij), opravili test pomnoževanja nukleinskih kislin, koščke tkiva pa smo histološko pregledali. Rezultati. Pregledali smo 50 bolnikov (15 žensk in 35 moških, povprečna starost 50,5 +-15,1 leta) in ugotovili aktivno tuberkulozo pri 11 (22%) bolnikih. Najbolj reprezentativen vzorec je bil izpirek bronhija pri 73% bolnikov, izpirek krtače pri 45%, košček pljuč pri 36% in izmeček po bronhoskopiji pri 45% bolnikov. Zaključki. Aktivno pljučno tuberkulozo ugotavljamo s histološkim in/ali bakteriološkim pregledom bronhoskopskim odvzemkov, kadar z večkratnimi zaporednimi pregledi jutranjih izmečkov ne najdemo bacilov tuberkuloze.
Descriptors		TUBERCULOSIS, PULMONARY BRONCHOSCOPY PATIENT SELECTION PHYSICAL EXAMINATION SPUTUM LUNG NEOPLASMS