The Positive Rate of Acid-Fast Bacilli in Nephrectomized Tuberculous Tissue Sections Using Fluorescent Stains / 대한비뇨기과학회지

ABSTRACT

Diagnosis of tuberculosis is obviously presumptive unless tubercel bacilli have been identified in tissue sections or have been cultured from various clinical specimens or tuberculous lesions. But it is well known that the detection of acid-fast bacilli is extremely difficult in conventionally stained tissue sections especially when they contain only a few tubercle bacilli. Therefore fluorescent technique employing two dyes (Auramins-Rhodamine) which is capable of detecting this pathogen more readily is of considerable value. This fluorescent stain has proven decidedly more effective than the conventional Ziehl-Neelsen stain and is more easily performed. Tissue sections from 47 cases of nephrectomized specimens under the clinical diagnosis of renal tuberculosis were examined for tubercle bacilli by means of fluorescent stain technique, and the following conclusions were obtained. 1. Of 47 cases, 34(72%) proved to contain acid-fast bacilli. 2. Fluorescent stains for acid-bastacilli in tissue sections have a pathologically considerable value when differentiating the fibrosis owing to non-specific chronic inflammation from organized caseation necrosis. 3. In general, high positive rate was concerned with shorter duration of anti-tuberculosis chemotherapy before operation. 4. Our opinion is that autonephrectomized kidney should be removed for fear of recurrence and shortening the duration of treatment. 5. If the tissue culture is negative because tubercle bacilli have been killed or viable tubercle bacilli have been attenuated, the bacteriologic diagnosis can be established only by means of the fluorescent stain for acid-fast bacilli in tissue section. 6. The fluorescent stains for acid-fast bacilli in tissuesections should be done for the routine examinations of potentially tuberculous tissue sections as a diagnostic aid or the unique bacteriological diagnostic method.