Role of gastric lavage and broncho-alveolar lavage in the bacteriological diagnosis of childhood pulmonary tuberculosis.

ABSTRACT

OBJECTIVE: To compare the mycobacteriological yield from gastric lavage (GL) and bronchoalveolar lavage (BAL), in children with pulmonary tuberculosis. METHODS: 58 consecutive children with chest radiograph suggestive of tuberculosis and positive Mantoux test or a positive history of family contact with a case of tuberculosis were prospectively subjected to gastric lavage on three consecutive mornings and broncho-alveolar lavage on the last day. The samples were subjected to bacteriological isolation. RESULTS: Samples from 10 (17.2%) children grew Mycobaterium tuberculosis from gastric lavage and 12 children had their BAL positive for this bacteria(p>0.05). Overall mycobacterial isolation was possible in 20 patients (34.4%) as two children had grown Mycobacterim tuberculosis in GL as well as BAL. Addition of BAL to the diagnostic work up increased the mycobacteriological yield from 17.2% with gastric lavage alone to 34.4% when BAL was also performed (p=0.013). CONCLUSION: There is no difference in mycobacterial isolation rates from gastric lavage and BAL when studied in isolation. However, when both GL and BAL are used; these procedures complement each other to double the diagnostic yield.