JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v7i1.2608 jpsim.v7i1.2608 Original Research Diagnostic Yield of Fiber Optic Bronchoscopy Washings among Patients of Sputum Smear-Negative Pulmonary Tuberculosis Gureja Abdul Wahab awgureja@gmail.com * Mushtaq Bilal Hanif Asif Javaid Affaf Nusrullah Muhammad Khalid Faiza Abu Umara Medical & Dental College / Ali Fatima Hospital Lahore, Pakistan Tehsil Headquarter Hospital (THQ), Wazirabad Institute of TB & Chest Medicine, King Edward Medical University / Mayo Hospital Lahore, Pakistan Department of Pulmonology Sargodha Medical College Sargodha, Pakistan *Correspondence: Abdul Wahab Gureja (awgureja@gmail.com) 10 03 2026 2026 7 1 38 41 14 07 2025 12 01 2026 17 02 2026 Copyright © 2026 The Author(s) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

To assess the diagnostic efficacy of fiber-optic bronchoscopy (FOB) in identifying smear-negative pulmonary TB.

 Methodology

This cross-sectional study was carried out at Institute of TB & Chest Medicine, Mayo Hospital Lahore from 15-7-2024 to 15-1-2025. Before FOB, patients were instructed to abstain from eating for 6 hours. The FOB was performed with local anesthesia. The BF type Olympus bronchoscope was used. The bronchi were washed using normal saline & recovery of up to a quarter of the fluid by suction was judged adequate. The hospital lab confirmed the presence or absence of Mycobacterium Tuberculosis by staining bronchial washings for AFB. Direct microscopy showing between 1 and 9 AFB/HPF in a bronchial washings smear indicates positivity. This data was gathered in a hypothetical scenario

 Results

FOB had a 57.5% diagnostic yield for identifying PTB patients that were positive despite a negative sputum smear. Patients between the age of 16 and 32 and those between the age of 49 and 60 had the greatest diagnostic yield (37%). However among patients of 33-48 years, diagnostic yield was 26.1% only. For both genders diagnostic yield for FOB was 50%. Diagnostic yield of FOB increases with increasing duration of symptoms. However patient’s age, gender and duration of symptoms was not significantly associated with diagnostic yield of FOB.

 Conclusion

Our findings support the use of FOB for the quick and accurate identification of MTB in sputum smear negative patients who have clinical and/or radiological features of Pulmonary TB

Keywords: Diagnostic yield, Fiberoptic Bronchoscopy, Smear Positive, Smear Negative, Pulmonary tuberculosis.

 Keywords Diagnostic yield Fiberoptic Bronchoscopy Smear Positive Smear Negative Pulmonary tuberculosis. Ethics Statement

Ethics committee: Institutional Review Board / Ethics Committee (IRB/EC). Approval number: IMBB/BBBC/22/271, dated February 4, 2022.

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