Abstract
Aims: The purpose of this study was to determine the efficacy of saliva
as a sample for diagnosing pulmonary tuberculosis(T.B.) by looking for
acid fast bacilli in a direct smear and comparing it with sputum and to
determine whether the isolation of M. tuberculosis is from the lung or
disseminated through blood. Material and Methods : The study sample
consisted of 25 patients of both sexes. Age range was (17 - 65) years .
Approximately 2 ml of unstimulated mixed saliva from each subject and
parotid saliva were collected for direct smear for acid fast bacilli by
Ziehl-Nelson acid fast stain. Five samples were inoculated on Lowenstein
Jensen media and storenbrink media .Results: About 60% of unstimulated
mixed saliva revealed positive acid fast bacilli, while all samples of
parotid saliva showed negative acid fast bacilli. The five samples of
saliva which were inoculated on Lowenstein Jensen media and stonebrink
media showed positive culture. To our knowledge, we did not find any
study performed on saliva as a sample for diagnosis of pulmonary
tuberculosis to compare our finding with these studies, so the comparison
was made between the sensitivity of saliva and the sensitivity of sputum .
In this study, the sensitivity of direct smear of saliva for A.F.B was equal
to 60% of the sensitivity of sputum. The sensitivity of direct smear of
sputum for A.F.B. ranged from (22_x0001_80%). There were no clinical
manifestations like gummas; granulomas; ulcer; alveolar abscess and osteitis.
CONCLUSION: This clinical and laboratory study revealed that M
Tuberculosis which was present in the mixed saliva resulted from contact
of oral tissue with infected sputum; Mixed saliva was less efficient than
sputum in diagnosis of T.B. disease . Saliva can be inoculated on
different media and that newly diagnosed patients with T.B disease don't
have any clinical manifestations in the oral cavity.
