Diagnostic utility of fiberoptic bronchoscopy in hemoptysis patients with unremarkable chest radiographs
DOI:
https://doi.org/10.71152/ajms.v16i8.4650Keywords:
Hemoptysis; Fiberoptic bronchoscopy; Normal chest X-ray; Bronchoalveolar lavage; TuberculosisAbstract
Background: Blood expectoration from the lower respiratory tract is known as hemoptysis. It possesses a diagnostic conundrum, especially when chest radiographs appear normal. The etiology may vary from infective pathologies to life-threatening diseases such as malignancies.
Aims and Objectives: The study aimed to evaluate the diagnostic yield of fiberoptic bronchoscopy (FOB) in patients with hemoptysis having unremarkable chest radiograph, to localize bleeding sites and identify underlying pathologies.
Materials and Methods: This prospective observational study was conducted at a tertiary care facility enrolling 52 hemodynamically stable patients aged ≥18 years who reported with hemoptysis and normal chest radiographs. Meticulous clinical history, physical examination, and pertinent investigations were performed following informed consent and institutional ethical authorization. Patients underwent FOB to detect bleeding sites and collect diagnostic samples such as bronchoalveolar lavage, which were then examined by cartridge-based nucleic acid amplification test, acid-fast bacilli smear/culture, potassium hydroxide mount, and cytology. Data were evaluated with acceptable statistical procedures.
Results: The study cohort’s mean age was 44.6±16.5 years, and 53.9% of them were male. Cough was the most common reported symptom (88.5%). FOB successfully localized the bleeding site in 40.4% of cases. Pulmonary tuberculosis emerged as leading etiology, accounting for 44.2%. In 13.5% of cases, no definitive diagnosis was established, necessitating further evaluation by other specialties.
Conclusion: FOB was well tolerated even in patients with moderate disease severity. FOB is a valuable and safe diagnostic tool. It facilitates localization of bleeding and identification of underlying causes.
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