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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.
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Pleural Effusion Overview
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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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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.
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Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
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Pediatric pleural tuberculosis.

Gulsum Iclal Bayhan1, Fuat Sayir2, Gonul Tanir3

  • 1Department of Pediatric Infectious Diseases, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey.

International Journal of Mycobacteriology
|September 11, 2018
PubMed
Summary

Pediatric pleural tuberculosis (TB) diagnosis can be challenging. Increased adenosine deaminase (ADA) levels in lymphocyte-predominant pleural effusions strongly suggest TB, even with uncomplicated effusions.

Keywords:
Childrenexudatepleuratransudatetuberculosis

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Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Diagnosing pleural tuberculosis (TB) in children presents challenges due to low microbiologic confirmation rates in pleural fluid.
  • Limited case series focusing on pediatric pleural TB exist in the literature.

Observation:

  • A retrospective review identified seven pediatric pleural TB cases.
  • Over half the cases (57.1%) had concurrent pulmonary TB, while 42.9% presented with isolated pleural TB.
  • Lymphocytic pleural effusion and elevated adenosine deaminase (ADA) levels (>40 U/L) were observed in 85.7% of patients.

Findings:

  • Lymphocyte-predominant pleural effusions with increased ADA levels are highly indicative of TB in pediatric patients.
  • Pleural TB can manifest as uncomplicated (transudate) effusion, not exclusively complicated (exudate) effusion.
  • All seven pediatric patients recovered completely after a 6-month anti-TB medication regimen.

Implications:

  • Elevated ADA levels in lymphocyte-predominant effusions can aid in diagnosing pediatric pleural TB, especially when microbiological confirmation is difficult.
  • Clinical awareness of both uncomplicated and complicated effusion types in pediatric pleural TB is crucial for appropriate management.
  • This case series contributes valuable data to the limited literature on pediatric pleural TB, informing diagnostic and treatment strategies.