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When patients with radiologic evidence of pulmonary tuberculosis are unable to produce sputum, diagnostic options include gastric lavage or bronchoscopy with bronchoalveolar lavage (BAL). How do these two options — neither particularly popular among patients — compare to the less invasive technique of inducing sputum with hypertonic saline?
British researchers evaluated 107 suspected TB patients using both sputum induction (performed 3 times on the same day) and gastric lavage (performed on 3 consecutive mornings); bronchoscopy with BAL was also performed on selected patients. The gold standard of diagnosis was a positive culture for Mycobacterium tuberculosis.
Sputum induction identified 42 of 46 patients with active TB, missing four cases i…