Evidence Based Medicine Case Report: Two Times Acid Fast Bacilli (AFB) Sputum Examination VS Three Times AFB Sputum Examination in The Diagnosis of Pulmonary Tuberculosis

· Case Report, Lung Infection

Kolanda Maria, Jaswin Dhillon, Linda Apriel Rolobessy, Mulkan Azhary, Vebiyanti Tentua, RR Diah Handayani, Jamal Zaini
Departemen Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Indonesia, RSUP Persahabatan, Jakarta

Diagnosis of active pulmonary tuberculosis (TB) still rely on the acid-fast bacilli (AFB) sputum smear. Pulmonary TB with three times sputum smear sometimes difficult to obtain duet to limitation of local resources, time, transportation and patient compliance. Literature search using Pubmed, SCOPUS, and EBSCO databases yield 3 relevant and full-text articles based on terms Pulmonary tuberculosis AND (three AFB
smears OR three sputum smears OR three sputum specimens OR two AFB smears OR two sputum smears OR two sputum specimens) AND sputum culture. Based on one systematic review, first AFB has sensitivity of 53.8%, and second AFB will increase the sensitivity of 11.1 and third AFB only will increase 3.1% sensitivity in the diagnosis of pulmonary tuberculosis. There is no significant difference in terms of sensitivity and specificity of sputum AFB 3 times vs 2 times in the diagnosis of pulmonary TB based on 3 literatures. (J Respir Indo. 2017; 37: 249-56)

Keywords: TB, AFB

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