The role of bronchoscopy in the diagnosis and management of pediatric pulmonary tuberculosis

Goussard, Pierre; Gie, Robert P.

doi:10.1586/17476348.2013.863712

Cited by 35 publications

(30 citation statements)

References 39 publications

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“…The tested specimens included gastric lavage aspirates [10], sputum [11, 12], and stool specimens [13, 14]. Recently fiberoptic bronchoscopy is widely used to help in diagnosing and treating pulmonary TB, especially in those smear-negative cases and in cases who are difficult to cough up sputum, like children [15]. This study evaluated the diagnostic value of the Xpert MTB/RIF assay on childhood pulmonary TB (PTB) using BALF.…”

Section: Introductionmentioning

confidence: 99%

Rapid Diagnosis of Childhood Pulmonary Tuberculosis by Xpert MTB/RIF Assay Using Bronchoalveolar Lavage Fluid

Yin

Jiao

Han

et al. 2014

BioMed Research International

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In order to evaluate the diagnostic accuracy of the Xpert MTB/RIF assay on childhood pulmonary tuberculosis (PTB) using bronchoalveolar lavage fluid (BALF), we evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of Xpert MTB/RIF assay using BALF in comparison with acid-fast bacilli (AFB) microscopy and Mycobacterium tuberculosis (MTB) culture for diagnosing childhood PTB using Chinese “composite clinical reference standard” (CCRS) as reference standard. Two hundred fifty-five children with suspected PTB were enrolled at Beijing Children's Hospital from September 2010 to July 2013. Compared with Chinese CCRS, the sensitivity of AFB microscopy, MTB culture, and Xpert MTB/RIF assay was 8.4%, 28.9%, and 53.0%, respectively. The specificity of three assays was all 100%. Xpert MTB/RIF assay could detect 33.9% of cases with negative MTB culture, and 48.7% of cases with negative AFB microscopy. Younger age (<3 years), absence of BCG scar, and contact with TB patient were found significantly associated with a positive result of Xpert MTB/RIF assay. In conclusion, Xpert MTB/RIF assay using BALF can assist in diagnosing childhood PTB much faster when fiberoptic bronchoscopy is necessary according to the chest radiograph.

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Section: Introductionmentioning

confidence: 99%

Rapid Diagnosis of Childhood Pulmonary Tuberculosis by Xpert MTB/RIF Assay Using Bronchoalveolar Lavage Fluid

Yin

Jiao

Han

et al. 2014

BioMed Research International

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“…In a recent prospective study of 56 children with non-cystic fibrosis bronchiectasis, FB and BAL have contributed to changing the therapeutic management in 25 cases 13 . However, although FB helps assess the airways disease in pulmonary tuberculosis 14,15 , the BAL yield is limited. In a 255 children's BAL analysis, the acid-fast bacilli microscopy sensitivity and Mycobacterium tuberculosis culture was 8.4% and 28.9% respectively 16 .…”

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confidence: 99%

Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

et al. 2016

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Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children's respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. Results: We performed 365 FB in 333 patients aged 46 months on average (1 month -15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%). Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician. Tunisia. Afri Health Sci. 2016;16(1): 51-60. http://dx.doi.org/10.4314/ahs.v16i1.7 Introduction Pediatric pulmonology has experienced significant progress in recent decades in the understanding and management of respiratory diseases of children, becoming a specialty in itself. The development of diagnostic tools, including flexible bronchoscopy (FB), has contributed much to the development of this specialty.

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“…Airway compression is more severe in children younger than 24 months 15 . Bronchoscopy does not only confirm the diagnosis but provides a functional and anatomical evaluation of the airway involvement in pulmonary TB, which in addition to raising the suspicion of TB lymph node compression of the airway also guides treatment 21 .…”

Section: Discussionmentioning

confidence: 99%

The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV

Webster

Goussard

Gie

et al. 2017

Expert Review of Respiratory Medicine

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Bronchoscopy is an important investigation in the diagnosis and management of childhood respiratory diseases widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC). Aims and Objectives:Aim of this study was to describe the indications, findings and complications of paediatric bronchoscopy in a middle income country with a high prevalence of tuberculosis (TB) and HIV. Methodology:A retrospective analysis of a database which included all bronchoscopies on neonates and children over a 3.5 year period (January 2010 to June 2013) in a tertiary care children's hospital in South Africa. Results and Discussion:A total of 509 bronchoscopies, of which 502 (98%) were fibre-optic bronchoscopies, were performed on neonates (2.3%) and children (median age = 18 months; range 1 day-14.6 years)( (male=58%) of which 5.1% were HIV-infected. The main indications were: large airway compression 40% (n = 204) complicated pneumonia (25 %) and persistent stridor (15 %). Pathology was observed in 64% (n = 319) of bronchoscopes . The most common pathology seen was lymph node compression of the airways (21%), and upper airway pathology (12%). Interventional procedures were performed in 112 cases (22%), the commonest being removing foreign bodies removal (30%), endobronchial lymph node enucleation (30%) and transbronchial needle aspiration (20%). No major complications occurred during or following bronchoscopy. ConclusionThe diagnostic yield of paediatric bronchoscopy did not significantly differ from those reported from high income countries emphasising the importance of paediatric bronchoscopy in the management of childhood lung disease in LMICs.

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The role of bronchoscopy in the diagnosis and management of pediatric pulmonary tuberculosis

Cited by 35 publications

References 39 publications

Rapid Diagnosis of Childhood Pulmonary Tuberculosis by Xpert MTB/RIF Assay Using Bronchoalveolar Lavage Fluid

Rapid Diagnosis of Childhood Pulmonary Tuberculosis by Xpert MTB/RIF Assay Using Bronchoalveolar Lavage Fluid

Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV

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