Related Experiment Video
Updated: May 11, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Can tuberculous pleural effusions be diagnosed by pleural fluid analysis alone?
S A Sahn1, J T Huggins, M E San José
1Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. sahnsa@musc.edu
Summary
Pleural fluid analysis (PFA) can diagnose tuberculous pleural effusion (TPE) in about one-third of cases. Specific markers like high protein, lymphocyte percentage, and adenosine deaminase (ADA) levels indicate TPE with high specificity.
Area of Science:
- Pulmonary Medicine
- Infectious Diseases
- Diagnostic Accuracy
Background:
- Tuberculous pleural effusion (TPE) diagnosis can be challenging.
- Pleural fluid analysis (PFA) is a key diagnostic tool.
Purpose of the Study:
- To evaluate the diagnostic confidence of PFA for TPE.
- To identify specific PFA parameters indicative of TPE.
Main Methods:
- Analysis of PFA from 548 TPE cases and control groups (MPE, IPE, MisPE, TrPE).
- Comparison of pleural fluid parameters including glucose, pH, cholesterol, triglycerides, ADA, and cell differentials.
Main Results:
- Significant differences in pleural fluid parameters (glucose, pH, cholesterol, triglycerides, ADA, cell percentages) between TPE and other effusions.
- 99.1% of TPEs were exudates.
- Pleural fluid protein ≥ 5.0 g/dl, lymphocytes > 80%, and ADA > 45 U/l showed 100% specificity for TPE.
Conclusions:
- PFA alone is diagnostic in approximately one-third of TPE cases.
- High probability of TPE diagnosis with specific PFA findings.
- PFA is a valuable tool, especially when combined with clinical suspicion.
Related Concept Videos
01:26Pulmonary Tuberculosis IV
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:25Pleural Effusion I: Introduction
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
01:28Pleural Effusion II: Symptoms and Management
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:31Pulmonary Tuberculosis III
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
01:28Pulmonary Tuberculosis II
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:26Endoscopic Studies II: Thoracocentesis
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...