587. Histopathology is Useful for the Rapid Diagnosis of Smear-Negative Pulmonary TB Cases in a Developing Country
Session: Poster Abstract Session: TB: Mycobacteria Diagnostic Testing
Thursday, October 8, 2015
Room: Poster Hall
Background: Three people die of TB every minute worldwide. More than 80% of the cases are Pulmonary TB (PTB), which is 100% responsible of the disease transmission. The sputum smear microscopy is the most used tool for TB diagnosis in low and middle-income countries; it is an inexpensive, fast, and specific method, but is not highly sensitive. Colombia is a developing country with an estimated TB incidence of 32 cases per 100000 people and where more than 40% of the total cases are Sputum Smear-Negative (SSN). This condition is a common problem faced by clinicians in every part of the world and according to epidemiology studies could be responsible even of 40% of the disease spread. In such cases the histopathology of the lung tissue is a helpful diagnostics tool. Objective. To describe and analyze retrospectively at a university hospital in Bogotá, Colombia the usefulness of histopathological examination of lung biopsies in the rapid diagnosis of cases SSN PTB-culture positive, which were collected over a six years period. 

Methods: Pathological, microbiological and clinical databases from Jan-2008 to May-2014, were reviewed. Two Pulmonary Pathologist independently, using Hematoxylin-Eosin and Ziehl-Neelsen stains, were who evaluated each biopsy study. When was necessary, the staining and study process was repeated and was discussed together other pathologists.

Results: 95 PTB cases were diagnosed by solid media-culture, of which in 58 a lung biopsy was taken; of all only 2 cases were Sputum Smear Positive. The culture positive samples were 49 BAL; 27 sputa and 19 lung biopsies. 47 transbronchial biopsies and 11 open lung biopsies were studied histologically. Necrotic granulomas were the most frequent finding (81%); 39 (67%) biopsies showed acid-fast Bacilli in the ZN stain. The histopathology and clinical features favored the rapid diagnosis of PTB in 90% of the evaluated cases. 24 hours was the average time for informing results in each case.

Conclusion: According to our results, the lung biopsy histopathology is an excellent tool for rapidly diagnosing PTB in Colombia. 

Leonardo Jurado, MD, UNINAVARRA, Neiva, Colombia and Diana Palacios, MD, Pathology, FSFB, Bogota, Colombia

Disclosures:

L. Jurado, None

D. Palacios, None

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