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Pleural tuberculosis.

B Chakrabarti1, P D O Davies

  • 1Aintree Chest Centre, University Hospital Aintree, Liverpool, United Kingdom. biz@doctors.org.uk

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|May 17, 2006
PubMed
Summary
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Tuberculosis pleural effusions, often seen in young adults, are shifting in epidemiology due to HIV and re-activation disease. Diagnosis relies on pleural biopsy, with ongoing evaluation of PCR and ADA tests.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Immunology

Background:

  • Tuberculosis (TB) pleurisy traditionally affects young adults post-primary infection.
  • Changing demographics include increased HIV co-infection and re-activation TB causing pleural effusions.
  • Tuberculous empyema is less frequent in Western countries but offers higher diagnostic yield from pleural fluid.

Purpose of the Study:

  • To review the epidemiology and diagnostic approaches for tuberculous pleurisy.
  • To discuss current diagnostic mainstays and emerging techniques.
  • To evaluate treatment outcomes and the role of corticosteroids.

Main Methods:

  • Review of existing literature on tuberculous pleurisy.
  • Emphasis on pleural biopsy (histology and culture) as the primary diagnostic tool.

Related Experiment Videos

  • Discussion of ancillary diagnostic methods like PCR and adenosine deaminase (ADA) levels.

    • Main Results:

    • Closed needle biopsy is sufficient for diagnosis in most cases.
    • PCR and ADA levels are under evaluation as supplementary diagnostic aids.
    • Antituberculous chemotherapy is generally effective for treatment.

    Conclusions:

    • Pleural biopsy remains the cornerstone for diagnosing tuberculous pleurisy.
    • Current evidence does not support routine corticosteroid use in treatment.
    • Understanding evolving epidemiology is crucial for effective management.