A comparative study of sputum induction in suspected pulmonary tuberculosis

A fairly good number of cases, strongly suspected of pulmonary tuberculosis (TB) are not confirmed bacteriologically, due to non-availability of diagnostic material like sputum. In this study, we made an attempt to collect adequate sample of secretions from the lower airways in subjects who do not produce sputum spontaneously and compare sputum induction between nebulized levosalbutamol, 0.9% normal saline, and 3% hypertonic saline. About 120 patients with suspected pulmonary TB who fulfilled the inclusion criteria form our study group and randomly divided into three subgroups of 40 each receiving (a) levosalbutamol (1.26 mg), (b) 0.9% normal saline, and (c) 3% hypertonic saline. Sputum induction was successful in 90% of cases (in levosalbutamol group), 50% of cases (in 0.9% normal saline), and 97.5% of cases (in 3% hypertonic saline group). It is concluded that 3% hypertonic saline nebulization produced maximum positivity (97.5%) for Acid Fast Bacilli (AFB) suspected cases of TB compared to levosalbutamol and normal saline nebulization.