Pediatric pleural tuberculosis

Int J Mycobacteriol. 2018 Jul-Sep;7(3):261-264. doi: 10.4103/ijmy.ijmy_91_18.

Abstract

Background: Pleural tuberculosis (TB) diagnosis is sometimes controversial because the microbiologic confirmation ratio is very low in pleural fluid. There are few pediatric pleural TB case series in the literature.

Methods: We retrospectively evaluated our TB cases below 18 years of age and extracted pleural TB cases.

Results: Seven cases with pleural TB were identified. About 42.9% of the patients had isolated pleural TB whereas 57.1% of the patients had accompanying pulmonary TB. Lymphocytic pleural effusion and increased adenosine deaminase (ADA) (>40 U/L) level are found in 85.7% of the patients. Six patients had uncomplicated effusion (transudate) according to Light's criteria and one had complicated effusion (exudate). Lung decortication was needed in three patients. All patients were given 6 months anti-TB medication and recovered completely.

Conclusion: In the lymphocyte-predominant pleural effusion, an increased ADA level highly supported TB disease. The complicated effusion (exudate) in pleural TB is not rule; uncomplicated effusion (transudate) could be seen.

Keywords: Children; exudate; pleura; transudate; tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Adenosine Deaminase / analysis*
  • Adolescent
  • Antitubercular Agents / therapeutic use
  • Child
  • Exudates and Transudates / chemistry
  • Exudates and Transudates / cytology
  • Female
  • Humans
  • Male
  • Pleural Effusion / immunology
  • Pleural Effusion / microbiology*
  • Radiography
  • Retrospective Studies
  • Thorax / diagnostic imaging
  • Treatment Outcome
  • Tuberculosis, Pleural / diagnosis*
  • Tuberculosis, Pleural / drug therapy

Substances

  • Antitubercular Agents
  • Adenosine Deaminase