creators_name: Vishnu, SM creators_name: Pradeep, NP creators_name: Anupama, N creators_name: Mithra, PP creators_id: drvishnusharmag@gmail.com editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2010-09-13 03:52:01 lastmod: 2011-03-11 08:57:44 metadata_visibility: show title: Bronchoscopic evaluation and final diagnosis in patients with chronic non productive cough with normal Chest X ray ispublished: pub subjects: OJHAS full_text_status: public keywords: Chronic non productive cough, bronchoscopy, pulmonary tuberculosis abstract: When a proper detailed history, clinical examination, chest X ray and sputum analysis does not yield a definite diagnosis for the cause of chronic cough, bronchoscopy is indicated. We did a descriptive study among 39 patients who underwent bronchoscopic evaluation for chronic cough (more than 4 weeks) with normal chest X ray and without a prior definitive diagnosis. 16 out of 39 patients were diagnosed to have tuberculosis on analysis of the bronchial washings. 6 patients (66.67%) with left upper lobe mucosal inflammation were AFB smear positive. 5 patients ( 31.25 %) with normal bronchoscopy were AFB smear positive.4 out of 5 patients (80 %) with bilateral upper lobe mucosal inflammation were AFB smear positive. Pulmonary tuberculosis can present with chronic non productive cough and normal chest X ray. Bronchoscopy is helpful in establishing the diagnosis. When bronchoscopy shows bilateral or unilateral upper lobe bronchial mucosal inflammation, possibility of tuberculosis is high. Bronchoscopy can be normal in some patients with pulmonary tuberculosis with normal chest x ray and chronic non productive cough. The key message is that early pulmonary tuberculosis can present with chronic non productive cough and normal chest X ray without any other symptoms suggestive of tuberculosis. Bronchoscopy is helpful in establishing the diagnosis date: 2010-07-30 date_type: published publication: Online Journal of Health and Allied Sciences volume: 9 number: 2 publisher: Dr. B.S. Kakkilaya refereed: TRUE referencetext: 1. Sen RP, Walsh TE. Fiber optic bronchoscopy for refractory cough. Chest 1991;99:53. 2. Su WJ, Lee PY, Perng RP. Chest roetogenography guidelines in the selections of patients for fiberoptic bronchoscopy. Chest 1993;103: 1198 3. Gaude GS, Mathew I. Diagnostic yield of flexible broncoscopy in the current clinical practice in a tertiary care hospital. Indian J. Bronchology. 2007;2:131. 4. Debidas R. Diagnostic value of bronchial washings through flexible fiberscope. Lung India. 1991;9(4):149-152. 5. Foos L, Patuto N, Chhajed P, Tamm M. Diagnostic yield of flexible bronchoscopy in current clinical practice. Swiss Med Wkly. 2001;136:155-159 6. Anandan TP, Rajagopal PT, James RC. Clinical Profile of patients undergoing fibreoptic broncoscopy in a tertiary care setting. Indian J. Bronchology. 2006;1;58-71. 7. Conde MB, Soares SL, Mello FC, Rezende VM, Almedia LL, Reingold AL et al. Comparison of sputum induction with fibreoptic bronchoscopy in the diagnosis of tuberculosis: experience at an acquired immune deficiency syndrome reference center in Rio de Janeiro, Brazil. Am J Resp Crit Care Med 2000;162: 2238-40. 8. Bhatia GC, Hemavani al, Chilnis DS. Role of bronchoalveolar lavage in pulmonary infections. Lung India 2006;23:147-50 9. Yuksekol I, Bal S, Ozkan M, Balkan A, Bedirhan I, Tozkoparan E, Dermici N, Seber O. The value of fibreoptic bronchoscopy in the diagnosis of smear negative pulmonary tuberculosis. Tuberk Toraks 2003;51(4):405-9. 10. Mohan A, Pande JN, Sharma SK, Rattan A, Guleria R, Khilnani GC. Bronchoalveolar lavage in pulmonary tuberculosis: a decision analysis approach. QJ Med1995;88(4):269-76. 11. McWilliams T, Wells AU, Harrisons AC, Lindstrom S, Cameron RJ, Foskin E. Induced sputum and bronchoscopy in the diagnosis of pulmonary tuberculosis. Thorax2002;57:1010-1014. 12. Bibi H, Mosheyer A, Shisevov D, Feigenbaum D, Kurzbart E, Weiller Z. Should bronchoscopy be performed in the evaluation of suspected pediatric pulmonary tuberculosis? Chest 2002;122:1604-1608. 13. Lale AP. Role of bronchoscopy and allied procedures to evaluate over diagnosis of tuberculosis. Indian J Tuber 1999;46(3):193-196. citation: Vishnu, SM and Pradeep, NP and Anupama, N and Mithra, PP (2010) Bronchoscopic evaluation and final diagnosis in patients with chronic non productive cough with normal Chest X ray. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/7007/1/2010-2-8.pdf