Source: Annual Congress 2006 - Clinical aspects of tuberculosis
Disease area: Respiratory infections

Abstract

Background:
The prevalence of pleural tuberculosis (PT) in young men in our institution represents almost half the cases of pulmonary tuberculosis in the same age group. The aim of our study was to review diagnostic methods of PT in HIV negative young patients.
Methods: Between January and December 2005, 65 male patients (mean age:23.8 ± 3.64 years) were treated for PT in our hospital. All patients underwent medical history, physical examination, chest X-ray, tuberculin skin test, biochemical and cytological analysis and mycobacterial culture of the pleural fluid. Blind pleural biopsy (BPB) was performed for histological analysis and culture of pleural tissue.
Results: All patients had high clinical suspicion of tuberculosis. The tuberculin skin test was ≥ 10mm in 42 patients (64%), between 7-8mm in 15 (23%) and < 5mm in 8 patients (12%). The analysis of pleural fluid showed a protein level >30g/l in all patients and predominant pleural lymphocytosis in 53 (82%). Histological analysis revealed caseous granulomatous inflammation (CGI) in 31 patients (48%) and non-CGI in 30 patients (46%). Non specific inflammation was observed in 4 patients. Culture of pleural fluid was positive in 20 patients (31%) and culture of pleural tissue was positive in 29 patients (45%). The diagnostic yield of histology added to culture of pleural fluid and tissue was 68%. Non-CGI associated with clinical presentation was considered highly suggestive of tuberculosis in 21 patients (32%).
Conclusions: BPB was the main diagnostic method in PT providing a diagnosis in 44 patients (68%) either by histological findings of CGI or by culture of pleural tissue. If findings of non-CGI were added as strong presumptive criteria, the yield of BPB reached 97%.

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Citations should be made in the following way:
H. Haouichat, S. Benamara (Algiers, Algeria). Diagnosis of pleural tuberculosis in young male patients. Eur Respir J 2006; 28: Suppl. 50, 819

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