Diagnosis of Tuberculosis Pleurisy with Three Endoscopic Features via Pleuroscopy

Abstract

Background: Tuberculosis (TB) is a constant threat even with worldwide active public health campaign. Diagnosis of TB pleurisy is challenging in case of pleural effusion of unknown origin after aspiration analysis. The study was designated to demonstrate a simple image interpretation technique to differentiate TB pleurisy from non-TB pleurisy using semi-rigid pleuroscopy. Methods: The study retrospectively enrolled 117 patients who underwent semi-rigid pleuroscopy from April 2016 to August 2018 in a tertiary hospital. We analyzed the possibility of TB pleurisy using three simple pleuroscopic images via semi-rigid pleuroscopy. Results: Among 117 patients, 28 patients (23.9%) were diagnosed with TB pleurisy. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 20 (71.4%), 20 (71.4%), and 19 (67.9%) patients with TB pleurisy, respectively. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 6 (6.7%), 37 (41.6%), and 0 (0.0%) patients with non-TB pleurisy, respectively. The positive and the negative predictive values of any two out of three pleuroscopic patterns for TB pleurisy were 100.0% and 93.7%, respectively. Conclusions: A high positive predictive value for TB pleurisy was demonstrated by the presence of any two out of the three characteristic features. Absence of all three features had an excellent negative predictive value for TB pleurisy. Our diagnostic criteria reconfirm that pleuroscopic images can be used as predictors for TB pleurisy.

Pleuroskopi Sebagai Tindakan Diagnostik pada Paru

“…Pleuroskopi memberikan hasil diagnostik yang tinggi dalam hal diagnosis pleuritis TB dan jenis pleuritis lainnya. 12,13 Pneumotoraks Pleuroskopi pada pneumotoraks spontan, dapat ditemukan blebs dan bula. Selain itu, juga memungkinkan koagulasi blebs, dan mencegah kekambuhan dengan metode seperti abrasi pleura atau talc pleurodesis.…”