Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis

Abstract Aim of this study was to compare the diagnostic yield of induced sputum (IS) and bronchoalveolar lavage (BAL) in patients with suspected pulmonary tuberculosis (PTB) and negative sputum smears. We enrolled 215 patients who underwent both IS and BAL after two negative spontaneous sputum samp...

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Main Authors: Maria Musso, Gina Gualano, Paola Mencarini, Annelisa Mastrobattista, Maria Angela Licata, Carlo Pareo, Carlotta Cerva, Silvia Mosti, Virginia Di Bari, Raffaella Libertone, Carla Nisii, Angela Cannas, Assunta Navarra, Delia Goletti, Fabrizio Palmieri
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Infectious Diseases
Online Access:https://doi.org/10.1186/s12879-025-11020-3
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author Maria Musso
Gina Gualano
Paola Mencarini
Annelisa Mastrobattista
Maria Angela Licata
Carlo Pareo
Carlotta Cerva
Silvia Mosti
Virginia Di Bari
Raffaella Libertone
Carla Nisii
Angela Cannas
Assunta Navarra
Delia Goletti
Fabrizio Palmieri
author_facet Maria Musso
Gina Gualano
Paola Mencarini
Annelisa Mastrobattista
Maria Angela Licata
Carlo Pareo
Carlotta Cerva
Silvia Mosti
Virginia Di Bari
Raffaella Libertone
Carla Nisii
Angela Cannas
Assunta Navarra
Delia Goletti
Fabrizio Palmieri
author_sort Maria Musso
collection DOAJ
description Abstract Aim of this study was to compare the diagnostic yield of induced sputum (IS) and bronchoalveolar lavage (BAL) in patients with suspected pulmonary tuberculosis (PTB) and negative sputum smears. We enrolled 215 patients who underwent both IS and BAL after two negative spontaneous sputum samples. PTB was confirmed by culture or molecular test in 26 patients (12.1%). IS detected 10 cases (38.5%) of all PTB, while BAL detected 22 cases (84.6%) of all PTB. IS had a sensitivity of 38.46% and a specificity of 100%, while BAL had a sensitivity of 84.62% and a specificity of 100%. BAL had a higher diagnostic yield than IS and was useful for ruling out alternative diagnoses. According to our experience FBS execution is mandatory in case of strong TB suspicion and sputum smear negative patients, especially in a low TB prevalence country. Moreover, it consents testing microorganism sensitivity and assessing possible alternative diagnosis with similar clinical presentation. The choice of the best diagnostic method may depend on the clinical context and the availability of resources.
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spelling doaj-art-3b64bf0563624624a8f73295b8a5feaa2025-08-20T02:15:16ZengBMCBMC Infectious Diseases1471-23342025-05-012511610.1186/s12879-025-11020-3Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosisMaria Musso0Gina Gualano1Paola Mencarini2Annelisa Mastrobattista3Maria Angela Licata4Carlo Pareo5Carlotta Cerva6Silvia Mosti7Virginia Di Bari8Raffaella Libertone9Carla Nisii10Angela Cannas11Assunta Navarra12Delia Goletti13Fabrizio Palmieri14Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSMicrobiology Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSMicrobiology Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSDepartment of Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCSTranslational Research Unit, National Institute for Infectious Diseases (INMI) “Lazzaro Spallanzani”- IRCCSRespiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSAbstract Aim of this study was to compare the diagnostic yield of induced sputum (IS) and bronchoalveolar lavage (BAL) in patients with suspected pulmonary tuberculosis (PTB) and negative sputum smears. We enrolled 215 patients who underwent both IS and BAL after two negative spontaneous sputum samples. PTB was confirmed by culture or molecular test in 26 patients (12.1%). IS detected 10 cases (38.5%) of all PTB, while BAL detected 22 cases (84.6%) of all PTB. IS had a sensitivity of 38.46% and a specificity of 100%, while BAL had a sensitivity of 84.62% and a specificity of 100%. BAL had a higher diagnostic yield than IS and was useful for ruling out alternative diagnoses. According to our experience FBS execution is mandatory in case of strong TB suspicion and sputum smear negative patients, especially in a low TB prevalence country. Moreover, it consents testing microorganism sensitivity and assessing possible alternative diagnosis with similar clinical presentation. The choice of the best diagnostic method may depend on the clinical context and the availability of resources.https://doi.org/10.1186/s12879-025-11020-3
spellingShingle Maria Musso
Gina Gualano
Paola Mencarini
Annelisa Mastrobattista
Maria Angela Licata
Carlo Pareo
Carlotta Cerva
Silvia Mosti
Virginia Di Bari
Raffaella Libertone
Carla Nisii
Angela Cannas
Assunta Navarra
Delia Goletti
Fabrizio Palmieri
Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis
BMC Infectious Diseases
title Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis
title_full Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis
title_fullStr Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis
title_full_unstemmed Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis
title_short Diagnostic yield of induced sputum and Bronchoalveolar lavage in suspected pulmonary tuberculosis
title_sort diagnostic yield of induced sputum and bronchoalveolar lavage in suspected pulmonary tuberculosis
url https://doi.org/10.1186/s12879-025-11020-3
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