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Pleural tuberculosis in patients with and without AIDS.

W A Ankobiah1, P Finch, S Powell

  • 1Division of Pulmonary Medicine, State University of New York, Brooklyn 11203.

Journal of the Association for Academic Minority Physicians : the Official Publication of the Association for Academic Minority Physicians
|January 1, 1990
PubMed
Summary

Pleural tuberculosis in patients with acquired immunodeficiency syndrome (AIDS) may present without respiratory symptoms. However, clinical and epidemiological features are similar to non-AIDS patients, with radiologic findings suggesting disseminated infection.

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Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Immunology

Background:

  • Pleural tuberculosis (TB) is a significant extrapulmonary manifestation of Mycobacterium tuberculosis infection.
  • Acquired immunodeficiency syndrome (AIDS) can alter the presentation and progression of infectious diseases, including TB.

Purpose of the Study:

  • To compare the epidemiologic and clinical features of pleural TB in patients with and without AIDS.
  • To analyze pleural fluid composition differences between AIDS and non-AIDS patients with pleural TB.

Main Methods:

  • Retrospective review of medical records of 71 patients with pleural TB.
  • Comparison of demographic, clinical, radiologic, and laboratory data between AIDS and non-AIDS groups.
  • Analysis of pleural fluid and pleural biopsy findings.

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Main Results:

  • AIDS patients were more likely to be intravenous drug abusers and present without respiratory symptoms.
  • No significant differences were found in pleural fluid or biopsy analyses between groups.
  • AIDS patients showed more chest roentgenographic infiltrates, hilar/mediastinal adenopathy, and bilateral effusions.
  • Higher rates of sputum smear/culture positivity for mycobacteria were observed in AIDS patients.
  • Acid-fast bacilli culture yield from pleural fluid was high (60%) irrespective of AIDS status.

Conclusions:

  • AIDS patients with pleural TB may present atypically without respiratory symptoms.
  • Pleural TB in AIDS patients often indicates disseminated mycobacterial infection.
  • Despite some differences in presentation and radiologic findings, pleural TB shares many features across AIDS and non-AIDS populations.