Tuberculous pleuritis: a not always immediate diagnosis
Key words: Tuberculous pleuritis, Diagnosis, Treatment, Case report
Tuberculous pleuritis usually presents as an acute illness with fever, cough and pleuritic
chest pain. The pleural fluid is an exudate that usually shows predominant lymphocytes.
Pleural fluid cultures are positive for Mycobacterium tuberculosis in less than 40% and
sputum is virtually always negative. In questionable cases the diagnosis can be established
by demonstrating granulomas or organisms on tissue specimens obtained via needle
biopsy of the pleura or thoracoscopy. The chemotherapy for tuberculous pleuritis is
the same as that for pulmonary tuberculosis. The present paper reports a case of a 17-
year-old girl with pleural effusion, without parenchymal disease. Tuberculin skin test,
bacterial and AFB cultures as well as cytology are negative. The diagnosis of tuberculous
pleural effusion is established by demonstrating granuloma in the parietal pleura
and by a positive AFB stain.
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