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Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
Mycobacterium tuberculosis and polymorphonuclear pleural effusion: incidence and clinical pointers.
Ming-Tzer Lin1, Jann-Yuan Wang, Chong-Jen Yu
1Department of Internal Medicine, Division of Chest Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.
Respiratory Medicine
|February 17, 2009
Summary
Early identification of Mycobacterium tuberculosis (MTB) in polymorphonuclear cell (PMN)-predominant pleural effusions is crucial. Clinical pointers like weight loss and initial low leukocyte counts can aid in diagnosing tuberculous pleurisy, improving patient outcomes.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- Delayed diagnosis of Mycobacterium tuberculosis (MTB) in polymorphonuclear cell (PMN)-predominant pleural effusion leads to poor outcomes and transmission risk.
- Investigating clinical differences in PMN-predominant pleural effusions caused by MTB versus other microorganisms is essential for timely intervention.
Purpose of the Study:
- To compare the clinical characteristics of patients with PMN-predominant pleural effusion due to MTB versus other pathogens.
- To identify clinical factors suggestive of tuberculous pleurisy in patients with PMN-predominant pleural effusions.
Main Methods:
- Retrospective analysis of 354 patients with tuberculous pleurisy from January 2000 to April 2007.
- Comparison of 39 adults with MTB-associated PMN-predominant pleural effusion against 117 age/gender-matched controls with PMN-predominant pleural effusions from other causes.
Main Results:
- Mycobacterium tuberculosis accounted for 5.2% of PMN-predominant septic pleural effusions.
- Independent predictors for tuberculous pleurisy included weight loss, initial leukocyte count ≤11,000/µL, and poor response to antibiotics.
- A shift to mononuclear cell predominance within one week and delayed anti-tuberculosis treatment (>14 days) were associated with worse prognosis.
Conclusions:
- Clinical suspicion can identify MTB in approximately 5.2% of patients with PMN-predominant septic pleural effusions.
- Recognizing specific clinical pointers facilitates early diagnosis and improves outcomes for tuberculous pleurisy.
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