To investigate the relationship between the number of negative acid-fast bacilli (AFB) smear results and infectivity of pulmonary tuberculosis (TB).
Study medical officers referred HIV-seropositive patients with negative acid-fast bacilli (AFB) smears for bronchoscopy with bronchoalveolar lavage (BAL).
PTB suspects were included after at least two negative Acid Fast Bacilli (AFB) smears in conventional sputum specimens either at a first line health facility or at the hospital level.
All these patients had negative acid-fast bacilli smears prior to endoscopy.
The relatively low number of organisms detected may explain the negative acid-fast bacilli smear and culture results (9 ).
For example, 2 patients had coughing symptoms improve during the 24-hour esophageal pH monitoring, which resulted in a negative acid regurgitation result.
We also thank Barennes and others for their suggestion that paragonimiasis is an important alternative diagnosis in patients with suspected tuberculosis but a negative acid-fast bacilli smear.
Despite the negative acid fast stain, a high level of suspicion for mycobacterial infection resulted in further testing and the eventual establishment of multiorgan involvement with Mycobacterium bovis BCG.
Dear Sir: We commend Suntornsut and others for reminding us that pulmonary melioidosis should be considered in every patient with a tuberculosis (TB like chest radiographic result and negative acid-fast bacilli (AFB) smears in melioidosis-endemic countries, such as Thailand.
Overall, medical residents appear to have significant knowledge gaps in several aspects of tuberculosis care, including the diagnosis and treatment of latent tuberculosis infection, and the correct interpretation of negative acid-fast smear sputum samples.
