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[Empiric antituberculous therapy in patients with unexplained exsudative pleural effusion. Is it valid in Senegal?]
M Sané1, K Ba-Fall, N Lefebvre
1Services médicaux, Hôpital Principal, Dakar, Sénégal.
Aim:
Pleural biopsy and adenosine deaminase activity are not available at our center and the treatment begins without substantiation diagnosis in patients with tuberculous pleural effusion (PE).
Methods:
In order to evaluate the validity of an empiric antituberculous therapy in exsudative PE with high prevalence of lymphocytes, we conducted a retrospective study during 1 year. Patient was enrolled if no signs of tuberculous infection, pneumonia or cancer were present.
Results:
During 1 year, 38 patients were enrolled (23 males, mean age=36 years). PE was major (> 2/3 of the lung) in 14 cases, moderate (between 1/3 and 2/3) In 18 cases and minor (<1/3) in 6 cases. Tuberculous contagion was observed in 10 patients. Tuberculinic test was positive in all patients (12-24 mm). Clinical and radiological cure was obtained in 37 cases, except 1 patient who died from acute heart failure. No recurrence of PE was observed after 1 year follow-up.
Conclusion:
In our endemic areas, empiric antituberculous treatment seems to be an effective strategy in patients with exsudative PE.
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