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Pleural tuberculosis: experiences from two centers in Brazil
Magda Lunelli1, Isabel Cristina Schütz Ferreira2, Muriel Bossle Sarmento3
1Universidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Ciências Pneumológicas, Porto Alegre, RS, Brazil; Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
Jornal De Pediatria
|May 22, 2022
Summary
Pediatric pleural tuberculosis is characterized by fever, cough, and chest pain. Biomarkers like adenosine deaminase aid in diagnosing this condition in children and adolescents.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pulmonology
Background:
- Pleural tuberculosis (TB) is a significant cause of illness in children, often presenting with nonspecific symptoms.
- Early and accurate diagnosis is crucial for effective management and preventing complications.
Observation:
- A retrospective study analyzed clinical and laboratory data of 92 pediatric patients with pleural TB in southern Brazil.
- Common symptoms included fever (88%), cough (72%), and chest pain (70%); 96% presented with unilateral pleural effusion.
Findings:
- Lymphocyte predominance was noted in 90% of pleural fluid samples.
- Adenosine deaminase (ADA) activity >40 U/L was found in 85% of patients, indicating tuberculous etiology.
- A significant proportion (76%) were initially misdiagnosed with community-acquired pneumonia.
Implications:
- Clinicians should consider tuberculosis in children with unilateral pleural effusion, especially with known TB contact.
- Pleural fluid biomarkers, including ADA, are valuable tools for diagnosing pleural TB in pediatric populations.
- Improved diagnostic strategies are needed to reduce misdiagnosis rates and ensure timely treatment for pediatric pleural TB.
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