Abstract: Objective To study the diagnostic value of fiberoptic bronchoscopy in atypical pulmonary tuberculosis with no sputum or negative sputum smear.  Methods Bronchial brushing, and rapid culture forMycobacterium tuberculosisin bronchoalveolar fluid(BALF) were performed for 201 cases with atypical pulmonary tuberculosis with no sputum or negative sputum smear and only 61 cases underwent transbronchial lung biopsy. All patients underwent sputum acid-fast staining andrapid culture forMycobacterium tuberculosisin sputum after using fiberoptic bronchoscopy.  Results  Of 201 cases,67.2%(135/201) were confirmed by bronchial brushing,83.6%(168/201) were confirmed by rapid culture forMycobacterium tuberculosisin BALF. Among the 61 cases underwent transbronchial lung biospy, pulmonary tuberculosis was confirmed in 39 cases(63.9%). Among the 201 cases underwent sputum acid-fast staining and rapid culture forMycobacterium tuberculosisin sputum after using fiberoptic bronchoscopy,28.9%(58/201) were confirmed by sputum acid-fast staining, 57.2%(115/201) were confirmed by rapid culture forMycobacterium tuberculosisin sputum.  Conclusion Fiberoptic bronchoscopy plays an important role in the diagnosis of atypical pulmonary tuberculosis with no sputum or negtive sputum acid-fast staining,and that rapid culture forMycobacterium tuberculosisin BALF is of significant value. It may increase the diagnosic rate of atypical pulmonary tuberculosis to apply different sampling Methods according to being found by the fiberoptic bronchoscopy.

Key words: tuberculosis,pulmonary/diagnosis, bronchoscopy