Source: Annual Congress 2008 - Diagnosis of tuberculosis: problems and perspectives
Disease area: Respiratory infections

Abstract

Background. It is widely accepted that tuberculous pleural effusion (TPE) is usually unilateral and develops slightly more often on the right side. We found no data concerning difference in course of TPE depending on the side of disease.
Study aim. To reveal if the side of TPE influences on course of the disease.
Methods. We retrospectively studied data on 178 patients, who were admitted for unilateral TPE between 1999 and 2007. All the patients were prisoners and had had equal access to up-to-date medical care. Majority of them (94.9%) were males. Average age was 28.3±0.6 years. No one of them previously had had TB history. Data on clinical presentations and some patterns of pleural fluid (PF) were studied. Ethics committees of both institutions approved the study.
Results. Left-sided effusion (LSE) was found in 96 (53.9%), more often than right-sided (RSE) – in 82 (46.1%) patients. Prodromal phase length was similar for both groups (1.2±0.1 months). Patients with LSE had more significant clinical and X-ray presentations than the ones with RSE.

Table 1

	LSE, patients	LSE, % in group	RSE, patients	RSE, % in group
Febrile body temperature	37	38.5	19	23.2
Dyspnoea at rest	11	11.5	2	2.4
Shadowing of more than 1/3 hemithorax on X-Ray	60	62.5	35	42.7

In the same time average protein level of PF was lower in LSE patients than in RSE patients – 75.0±6.8 and 98.9±7.6 g/l respectively (p<0.05). Average amount of aspirated PF was 2011.7±154.1 ml in LSE group and only 1283.9±151.2 ml in RSE group (p<0.05).
Conclusions. Obtained data suggest that clinical presentations of the left-sided tuberculous pleurisy are more significant than that of the right-sided disease. Further studies of the problem are needed.

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Citations should be made in the following way:
K. Vladimirov, A. Ivanov, V. Boikov, N. Panova (St.Petersburg, Russian Federation). Left-sided and right-sided tuberculous pleural effusion: is there any difference?. Eur Respir J 2008; 32: Suppl. 52, 2388

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