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PubMed1995

[The double band sign: pleural tuberculosis in x-ray computed tomography].

We described on computed tomography, two cases of pleural tuberculosis with parietal pleural enhancement and thickening associated with another external high density line. We called this parietal pleural and extra pleural change, the "double band sign". After study of the regional anatomy, we think that this external line is the endothoracic fascia.

Humans↗
PubMed1994

[Association of pseudochylothorax and pleural tuberculosis. Apropos of a case].

The authors report a case of pseudochylothorax revealed by pleural tuberculosis. Classically, pseudochylothorax is a late complication of chronical and calcified pleurisy especially sequellae of tuberculosis treated by induced pneumothorax. Treatment consist on thoracentesis or aspiration with frequent remove. Surgical decortication can be useful. Specific chemotherapy is only necessary in the patients in whom tuberculosis is present or never treated with antibiotics.

Aged↗
PubMed1983

Pleural tuberculosis evaluated by computed tomography.

Twenty-four cases of pleural tuberculosis (20 active and 4 inactive) were studied with computed tomography (CT). In 14 patients with proved acute tuberculous pleurisy, CT improved diagnostic accuracy by demonstrating small areas of cavitation not apparent on the chest radiograph and by detecting or confirming lymphadenopathy. In 10 patients with chronic tuberculous pleural disease, CT differentiated active from inactive infection by detecting a collection of fluid within the pleural rind. In both groups, CT also demonstrated complications such as bronchopleural fistula and involvement of the chest wall. CT can be beneficial in such cases because of its ability to show the pleural surfaces in transverse section, discriminate parenchymal from pleural disease, and quantify tissue density.

Adolescent↗
PubMed1996

Interferon-gamma in 388 immunocompromised and immunocompetent patients for diagnosing pleural tuberculosis.

The level of interferon-gamma (IFN-gamma) in pleural fluid has been reported to be increased in pleural tuberculosis. Nevertheless, its diagnostic value has not yet been well-established, and immunocompromised patients have not previously been evaluated. The aim of this study was to determine the value of the IFN-gamma level in pleural fluid for diagnosing tuberculous pleurisy in immunocompetent and immunocompromised patients. Three hundred and eighty eight consecutive patients were studied prospectively (73 with tuberculous pleural effusions, including nine with concurrent human immunodeficiency virus (HIV) infection and one after liver transplantation, and 315 with nontuberculous effusions). IFN-gamma was measured by radioimmunoassay. The sensitivity of the test, using a 3.7 U.mL-1 cut-off point, was 0.99 (95% confidence interval (95% CI) 0.93-1.00) and the specificity was 0.98 (95% CI 0.96-1.00). The sensitivity of the test did not differ in HIV-positive and HIV-negative patients. Patients with lymphoma, vasculitis or vascular connective tissue disease did not have abnormal IFN-gamma values. In conclusion, the level of interferon-gamma in pleural fluid is a very good diagnostic marker of tuberculous pleural effusion, even in immunocompromised patients.

AIDS-Related Opportunistic Infections↗
PubMed2005

The clinical utility of polymerase chain reaction for the diagnosis of pleural tuberculosis.

BACKGROUND: There is no exact consensus about the usefulness of the Mycobacterium tuberculosis polymerase chain reaction (PCR) testing for the diagnosis of tuberculous pleural effusion because of the diverse PCR methods and the different diagnostic criteria that are described in other studies. METHODS: We analyzed pleural effusion specimens obtained from 111 patients for whom the exclusion of the possibility of tuberculous pleural effusion was necessary. We performed M. tuberculosis PCR testing using the Cobas Amplicor MTB test (Roche Diagnostic Systems), which is fully automated and commercially available. RESULTS: Results of the M. tuberculosis PCR test of pleural effusion specimens were positive for 7 (17.1%) of the 41 patients with confirmed pleural tuberculosis and for 3 (18.8%) of the 16 patients with probable pleural tuberculosis. The overall sensitivity and specificity of M. tuberculosis PCR testing of pleural effusion were 17.5% and 98.1%, respectively. The sensitivity of M. tuberculosis PCR testing for each group of patients with tuberculous pleural effusion detected by smear-positive results, smear-negative and culture-positive results, and culture-negative and pleural biopsy-positive results, was 100.0%, 33.3%, and 3.7%, respectively. Of the 57 patients with pleural tuberculosis, only 3 (5.3%) had positive results of M. tuberculosis PCR testing along with negative results of smearing, negative results of pleural pathological analysis, and a low level of adenosine deaminase. CONCLUSION: For specimens such as pleural effusion, in which the bacillary load is very low, the clinical utility of PCR testing seems highly limited.

Adult↗
PubMedDate not supplied

[The clinical picture of pleural tuberculosis (based on the results of thoracoscopy in 500 patients with a pleural exudate)].

The author presents results of 500 thoracoscopies performed in 500 patients with pleural effusion. Tuberculosis and malignant tumors prevailed (51.8 and 20.8% respectively). Endoscopic examination of pleural cavity amplified by pleural biopsy and cytohistological study of obtained material was shown to be highly effective. In the author's opinion, wet pleurisy is sure to be a surgical problem. To solve it, he considers necessary to allocate 8-10 hospital beds for every 1.5 million of population (in thoracal department of surgical and pulmonological centres, TB dispensaries) right up to organization of pleural pathology departments.

Biopsy↗
PubMed1986

Short-course chemotherapy for pleural tuberculosis. Nine years' experience in routine treatment service.

Short-course chemotherapy (SCC) for pulmonary tuberculosis for nine months with isoniazid (INH) and rifampin (RIF) is well established. However, there is still no report on results of such therapy in pleural disease. From January 1976 through December 1984, we treated 201 patients (average age 61.6 years) for pleural tuberculosis, 143 with SCC for nine months of mainly INH and RIF and 58 with conventional therapy (CT) for 18 to 24 months. Findings indicated that SCC with INH and RIF was as effective as in pulmonary tuberculosis. The results were equivalent or even better than CT given for prolonged periods.

Adolescent↗
PubMed1996

[Factors associated with pleural thickening in pleural tuberculosis. Review of 99 cases].

OBJECTIVE: To analyze which factors were related to the development of pleural thickening in pleural tuberculosis (PT). METHODS: We reported 99 patients diagnosed as having PT separated into two different groups according to the presence of radiographic pleural thickening after completing the treatment: normal chest roentgenogram (group 1) or pleural thickening (group 2). We compared: clinical history, chest radiography, pleural fluid analysis, microbiological studies and effects of the treatment. RESULTS: 35 cases in group 1 (35.35%) and 64 in group 2 (64.45%). All the compared results did not differ between the two groups, excluding a higher incidence of febrile cases, increased white cell count and decreased relative percentage of pleural lymphocytes in group 1, and increased number of cases with hemoptysis, positive sputum cultures in patients with parenchymal infiltrates, relative percentage of pleural lymphocytes and decreased white cell count in group 2. CONCLUSIONS: We reported an elevated incidence of residual pleural thickening, but it is unlikely that all the cases could have any clinical significance. We didn't confirm a characteristic pattern. Our findings suggested that a different reaction related or not to the hypersensitivity, rather than the inflammatory response to infection was the responsible for the fibrosis.

Adolescent↗