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- Title
The tuberculous pleural effusion.
- Authors
McNally, Emma; Ross, Clare; Gleeson, Laura E.
- Abstract
Pleural tuberculosis (TB) is a common entity with similar epidemiological characteristics to pulmonary TB. It represents a spectrum of disease that can variably self-resolve or progress to TB empyema with severe sequelae such as chronic fibrothorax or empyema necessitans. Coexistence of and progression to pulmonary TB is high. Diagnosis is challenging, as pleural TB is paucibacillary in most cases, but every effort should be made to obtain microbiological diagnosis, especially where drug resistance is suspected. Much attention has been focussed on adjunctive investigations to support diagnosis, but clinicians must be aware that apparent diagnostic accuracy is affected both by the underlying TB prevalence in the population, and by the diagnostic standard against which the specified investigation is being evaluated. Pharmacological treatment of pleural TB is similar to that of pulmonary TB, but penetration of the pleural space may be suboptimal in complicated effusions. Evidence for routine drainage is limited, but evacuation of the pleural space is indicated in complicated disease.
- Subjects
TUBERCULOSIS diagnosis; DRUG therapy for tuberculosis; CHYLOTHORAX; BIOCHEMISTRY; INTERLEUKINS; BIOMARKERS; FIBRINOLYTIC agents; PLEURAL effusions; CHEST X rays; ADRENOCORTICAL hormones; INTERFERONS; INFECTION control; MYCOBACTERIUM tuberculosis; COMPUTED tomography; EMPYEMA; THORACOSCOPY; DISEASE management
- Publication
Breathe, 2023, Vol 19, Issue 4, p1
- ISSN
1810-6838
- Publication type
Article
- DOI
10.1183/20734735.0143-2023