Superheated Nebulized Saline and Gastric Lavage: To Obtain Bacterial Cultures in Primary Pulmonary Tuberculosis in Children

IN YOUNG children infected with tuberculosis, positive identification of the organism by culture is very important not only to make the definitive diagnosis but also to document the drug sensitivity of the infecting tubercle bacillus. These data allow continued measurement of the prevalence of drug resistant bacteria in a community. It has been conventional clinical practice to do early morning gastric aspiration in children on three successive days to obtain specimens for bacteriologic studies. Lincoln and Sewell 1 state in their excellent review book that... cultures obtained during the early phase of primary tuberculosis and before any antimicrobial therapy is given are most likely to be positive. Under the best conditions, bacilli have been recovered in 50% to 90% of all children with roentgenographic evidence of pulmonary primary tuberculosis, but in the average hospital only one quarter to one third of gastric lavages of children suspected of active tuberculosis yield