Application of High-Frequency Oscillation during Bronchoscopy in Smear-Negative Pulmonary Tuberculosis

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Viratch Tangsujaritvijit
Somcharoen Thienchairoj
Detajin Junhasavasdikul
Thotsaporn Morasert
Dararat Eksombatchai


Background: The diagnostic yield of bronchoalveolar lavage (BAL) for diagnosis of pulmonary tuberculosis (PTB) is low. The vibrator device is useful for sputum induction.

Objective: This trial was aimed to assess the value of high-frequency oscillation (HFO) during fiberoptic bronchoscopy (FOB) for diagnosis of patients with suspected PTB.

Methods: Suspected PTB patients with two consecutive negative sputum acid-fast bacilli (AFB) smears were recruited. Patients were chosen to use the HFO device by randomization, while the other patients underwent standard BAL. The BAL fluid and post-bronchoscopic sputum were processed for AFB smear and culture, and polymerase chain reaction for TB (PCR-TB).

Results: Eighty patients participating in this study, PTB was definitely diagnosed in 32 patients. The diagnostic yield of HFO with BAL culture was 27.8%, and non-HFO 21.1% (P = 0.71). The diagnostic yield of HFO with post-bronchoscopic sputum culture was 22.2%, and non-HFO 21.1% (P = 1.00). The diagnostic yield of PCR-TB with HFO was 33.3%, and non-HFO 21.1% (P = 0.47).

Conclusions: Addition of HFO during FOB did not result in significant differences in the diagnostic yield of PTB detection in smear-negative PTB patients. However, there was a trend of increasing sensitivity of BAL PCR-TB in patients receiving HFO.



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Tangsujaritvijit, V., Thienchairoj, S., Junhasavasdikul, D., Morasert, T., & Eksombatchai, D. (2017). Application of High-Frequency Oscillation during Bronchoscopy in Smear-Negative Pulmonary Tuberculosis. Ramathibodi Medical Journal, 40(2), 25-33. Retrieved from
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