Intrathoracic tuberculosis: Role of interventional bronchoscopy in diagnosis

Pierre Goussard; Ernst Eber; Shyam Venkatakrishna; Lisa Frigati; Jacques Janson; Pawel Schubert; Savvas Andronikou

doi:10.1016/j.prrv.2022.12.002

Intrathoracic tuberculosis: Role of interventional bronchoscopy in diagnosis

Paediatr Respir Rev. 2023 Mar:45:23-29. doi: 10.1016/j.prrv.2022.12.002. Epub 2022 Dec 16.

Authors

Pierre Goussard¹, Ernst Eber², Shyam Venkatakrishna³, Lisa Frigati⁴, Jacques Janson⁵, Pawel Schubert⁶, Savvas Andronikou³

Affiliations

¹ Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Electronic address: pgouss@sun.ac.za.
² Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
³ Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁴ Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
⁵ Department of Surgical Sciences, Division of Cardiothoracic Surgery, Stellenbosch University, and Tygerberg Hospital, Tygerberg, South Africa.
⁶ Division of Anatomical Pathology, Tygerberg Hospital, National Health Laboratory Service, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

PMID: 36621398
DOI: 10.1016/j.prrv.2022.12.002

Abstract

Tuberculosis (TB) is the leading cause of death from a single infectious agent globally. Mortality is related to the delay in diagnosis and starting treatment. According to new guidelines it is very important to classify pulmonary tuberculosis (PTB) as severe or not severe disease due to the difference in treatment duration. Bronchoscopy is the gold standard for assessing the degree of airway compression and obstruction in paediatric PTB. Paediatric bronchoscopy has evolved from a primarily diagnostic procedure to include interventional bronchoscopy for diagnostic purposes. Endobronchial ultrasound (EBUS) has increased the potential of sampling mediastinal lymph nodes both for histological diagnosis and microbiological confirmation.

Keywords: Flexible bronchoscopy; Interventional bronchoscopy; Pulmonary tuberculosis; Rigid bronchoscopy; Xpert MTB/RIF.

Publication types

Review

MeSH terms

Bronchoscopy* / methods
Child
Humans
Severity of Illness Index
Tuberculosis, Pulmonary* / diagnosis