The Indian Journal of Pediatrics

, Volume 54, Issue 1, pp 69–77 | Cite as

Diagnosis of intrathoracic tuberculosis by detection of tubercle bacilli and/or tubercular antigen (TB Ag) in bronchial aspirate

  • P. M. Udani
  • A. Samuel
  • G. V. Kadiwal
  • Vrajesh Udani
  • Soonu Patel
  • Alka Datar
  • S. A. Khatib
  • D. S. Sexena
Festschrift in Honour of Professor Harish Chandra, M.D., F.R.C.P.


Bronchial aspirates in 160 children were examined for tubercle bacilli and were positive in 55 (34·4%). Tubercular antigen was detected in 56 of 79 children (70·9%). In 60 children in whom AFB or TB antigen was positive in bronchial washing antigen was positive in more than 96·7% of cases, indicating high sensitivity of antigen test. Moreover, antigen is specific for human and bovine mycobacteria. Only 15% of children who had tuberculosis proved by +ve antigen or +ve smear presented with usual characteristic symptoms of tuberculosis. About 75% of the children presented with recurrent or persistent bronchitis or pertussoid syndrome, while in 9% of children there were no significant symptoms. Mediastinal lymphnode involvement is common in children and 80% of AFB/antigen positive cases had only mediastinal lymphnode disease, while 20 also had parenchymal lesions. For the diagnosis of tuberculosis a simple technique such as examination of throat secretions for detection of TB antigen by RIA technique or ELISA has great potential.

Key words

Tuberculosis Extent of problem Bronchial aspirates Tubercular antigen by RIA 


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  1. 1.
    Pamra SP. Problems of tuberculosis in developing countries.Clinics Chest Med 1980;1: 266–271Google Scholar
  2. 2.
    Indian Council of Medical Research National Sample Survey.ICMR special report No. 34 1959Google Scholar
  3. 3.
    Goyal SS, Mathur GP, Pamra SP. Tuberculosis trends in an urban community.Indian J Tuber 1978;25: 77Google Scholar
  4. 4.
    WHO Expert Committee on Tuberculosis Ninth Report (1974).World Health Organisation, Tech Rep Ser No. 552 Google Scholar
  5. 5.
    Udani PM. Incidence of Tuberculosis in children.Indian J Child Hlth 1961;10: 515Google Scholar
  6. 6.
    Udani PM. Tuberculosis in childhood.Pediatr Clin India 1968;3: 163–193Google Scholar
  7. 7.
    Udani PM, Bhat US, Bhave SK, Esuthachan SG, Shetty VV. Problem of tuberculosis in children in India, epidemiology, morbidity, mortality and control programme.Indian Pediatr 1976;881: 890Google Scholar
  8. 8.
    Udani PM. Evaluation of tuberculin test in practice in pediatrics.Indian Ped 1982a;19: 469–485Google Scholar
  9. 9.
    Udani PM. BCG test in the diagnosis of tuberculosis in children.Indian Ped 1982b;19: 563–581Google Scholar
  10. 10.
    Udani PM. Protective valee c BCG vaccine.Indian Ped 1982c;19: 739–752Google Scholar
  11. 11.
    Udani PM, Samuel AM, Udani VP, Patel, S, Khatib SA, Saxena DS, Study of bronchial aspirate for tubercle bacilli and its corelation to tuberculous antigen by RIA technique, preliminary report presented at theAnnual Meeting of IUAT, Paris, 1983Google Scholar
  12. 12.
    Bailey GVJ. Paper presented on prevention of tuberculosis prevention.Indian J Med Res 1979;70: 349–363Google Scholar
  13. 13.
    Gothi GD.BCG Workshop, New Delhi IAP 1980Google Scholar
  14. 14.
    Deshmukh PA. Personal communication. TB control and Training Centre, Nagpur, 1973Google Scholar
  15. 15.
    Shah PM, Udani PM. Medical examination of rural school children in Phalghar taluka.Indian Pediatr 1968;5: 343PubMedGoogle Scholar
  16. 16.
    Bleiker MA, Styblo K. The animal tuberculosis infection rate and its trend in developing countries.IUAT 1978;53: 295–298Google Scholar
  17. 17.
    Dhadiwal M, Udani PM. Principal causes of deaths in children under 12 years of age with special reference to contributory factors. Inst Child Hlth, JJ Group of Hospitals & GMC, Bombay 1976Google Scholar
  18. 18.
    Thomas T, Udani PM. Statistical comparative data of tuberculosis in children and adults with special reference to study of tuberculosis of abdominal organs in children. Inst Child Hlth, JJ Group of Hospitals & GMC, Bombay 1977Google Scholar
  19. 19.
    Alderman et al quoted by Udani PM. Evaluation of tuberculin test in pediatric practice.Indian Pediatr 1982;vol. 19 Google Scholar
  20. 20.
    Heil WC. The influence of cellular inflitrate on the evaluation and intensity of delayed hypersensitivity reaction.J Exp Med 1969;29: 363CrossRefGoogle Scholar
  21. 21.
    Krishnaswamy GV, Abdul Rahim M, Parthasarathi R, Raja MA. BCG test.Indian J Tuber 1979;26: 74Google Scholar
  22. 22.
    Choudhry VP, Singh MM, Verma IC. BCG and mantoux intradermal tests in the diagnosis of tuberculosis.Indian Pediatr 1974;11: 535PubMedGoogle Scholar
  23. 23.
    Mande J, Gaud G. Howal E, Dompart P, Bahrau J, Goujou. BCG vaccination campaign in North Africa quoted by Mande R, 1966Google Scholar
  24. 24.
    Bhandari NR, Bhambal SS, Srivastava V. Evaluation of diagnosis value of BCG test in childhood tuberculosis. Paper presented at the plenary session on BCG, XVII National Conference of Indian Academy of Pediatrics, Bangalore, 1980Google Scholar
  25. 25.
    Aggarwal V. Diagnostic value of BCG in childhood tuberculosis (unpublished data). Part of the dissertation for MD Pediatrics, University of Pune 1979Google Scholar
  26. 26.
    Pulsule N, Udani PM. Clinical and diagnostic evaluation of 100 autopsy proved cases of tuberculosis. Part of dissertation of M.D. Pediatrics, Bombay 1976Google Scholar
  27. 27.
    Fox TG. Occult tuberculosis infection in children.Tubercle, 1977;58: 91–96PubMedCrossRefGoogle Scholar
  28. 28.
    Kadiwal GV, Samuel AM, Virdi BS, Kale RN, Ganatra RD, Fernandes CS, Deshmukh MD. Radio-immuno-assay of tuberculous antigen.Indian J Med Res 1982;75: 765–770Google Scholar
  29. 29.
    Samuel AM, Kadiwal GV, Irani SZ, Pandya SK, Ganatra PD. A sensitive and specific method for diagnosis of tubercular meningitis.Indian J Med Res 1983;77: 752–757PubMedGoogle Scholar
  30. 30.
    Udani PM, Parekh UC, Nair PA. BCG test in tuberculosis children.Proceedings of the symposium organised by National Academy of Medical Sciences and WHO 1974; 125–136Google Scholar
  31. 31.
    Udani PM. Syndromes of subcarinal lymphnode tuberculosis in children.Proceedings of the XVI International Congress of Pediatrics: Abstract ID 1980;44: 399Google Scholar
  32. 32.
    Silver H and Sonnenwirth AC. Fluorescence microscopy technique as applied to the identification of acid-fast bacilli in tissue and bacteriological material.J Clin Path 1966;19: 583PubMedCrossRefGoogle Scholar
  33. 33.
    Sarkar SKet al. Fibre-optic bronchoscopy in the diagnosis of pulmonary tuberculosis.Tubercle 1981;61: 97–99CrossRefGoogle Scholar
  34. 34.
    Damak S, Bewer J. The role of fibreoptic bronchoscopy in the evaluation of pulmonary tuberculosis.Ame Rev Resp Dis 1979;119: 677.Google Scholar
  35. 35.
    So SY, Lam WK, Yu DYC. Rapid diagnosis of suspected pulmonary tuberculosis by fibreoptic bronchoscopy.Tubercle 1982;63: 195–200PubMedCrossRefGoogle Scholar
  36. 36.
    Strumpf IJ, Taand AY, Schork MA, Weg JG. The reliability of gastric smears by auramine—rhodamine staining technique for the diagnosis of tuberculosis.Am Rev Res Dis 1976;114: 971Google Scholar
  37. 37.
    Ramchandran RS. Tuberculosis in children: experience with 1284 cases.Indian Pediatr 1968;5: 564Google Scholar
  38. 38.
    Miller FJW, Seal RME, Taylor Mary D.Tuberculosis in children. London, Churchill, 1963Google Scholar
  39. 39.
    Miller FJW.Tuberculosis in children, evaluation epidemiology, treatment, prevention, Churchill Livingstone, Longman Group London and New York, p 28, 1982Google Scholar
  40. 40.
    Lincoln EN, Sewell EM.Tuberculosis in children. Blackiston division, McGraw-Hill Book Company, Inc, London, 1963; p 116.Google Scholar
  41. 41.
    Kotian M, Shivananda PG, Lalitha E, Harish B, Achyutha Rao KN. Colonisation of atypical mycobacteria in the normal respiratory tract.Indian J Tubercul 1983;30: 149–151Google Scholar
  42. 42.
    Goslee S, Wohinsky E. Water as a source partially pathogenic mycobacteria.Amer Rev Resp Dis 1976;113: 287PubMedGoogle Scholar
  43. 43.
    Rouillon A, Perdrizet S, Parrot R. Transmission of tubercle bacilli. The effect of chemotherapy.Tubercle 1976;57: 275PubMedCrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 1987

Authors and Affiliations

  • P. M. Udani
    • 1
  • A. Samuel
    • 1
  • G. V. Kadiwal
    • 1
  • Vrajesh Udani
    • 1
  • Soonu Patel
    • 1
  • Alka Datar
    • 1
  • S. A. Khatib
    • 1
  • D. S. Sexena
    • 1
  1. 1.Medical Research Centre, Bombay Hospital and Radiation Medical CentreBARCBombay

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