Tuberculous Pleural Effusion and Tuberculous Empyema

Abstract

Tuberculous pleuritis has increased worldwide, especially in developing countries, as a consequence of human immunodeficiency virus co-infection. Tuberculous pleuritis is a delayed hypersensitivity reaction against mycobacterial antigens in the pleural space. Mycobacteria are detected in less than 50% of pleural samples, but the characteristic pleural involvement, granulomas with or without caseous necrosis, is evident in 56 to 80% of cases from samples obtained by percutaneous pleural biopsy. Of several pleural fluid parameters studied, adenosine deaminase and interferon gamma (IFN-gamma) have the best diagnostic yield, while polymerase chain reaction remains a promising test. Treatment of patients with tuberculous pleuritis is discussed. Tuberculous empyema is a rare form of tuberculous pleuritis. It consists of a purulent infection of the pleural cavity with detectable bacilli in pleural fluid. Diagnosis is easily established clinically and bacteriologically. Treatment is to adequately drain the pleural space and achieve lung reexpansion, in conjunction with antituberculous chemotherapy. The efficacy of different surgical techniques is discussed.

Innate immune responses in murine pleural mesothelial cells: Toll-like receptor-2 dependent induction of β-defensin-2 by staphylococcal peptidoglycan

“…Infiltration of bacterial organisms into the pleural space during pleural effusion is a well-described complication of pneumonia (13,14,63). Pleural effusion may also result from viral infection of the lungs especially due to epidemic pleurodynia, an infection usually caused by coxsackie viruses or echo viruses (25).…”

Percentage reduction of pleural effusion as a simple predictor of pleural scarring in tuberculous pleuritis

“…TB pleural effusion is a common form of extra‐pulmonary TB 12 . Despite effective anti‐TB chemotherapy, some patients still develop RPS.…”

“…TB pleural effusion is a common form of extrapulmonary TB. 12 Despite effective anti-TB chemotherapy, some patients still develop RPS. The extent of pleural scarring often varies and can range from minimal pleural thickening, with no physiological impairment, to severely thickened visceral pleura separated from the chest wall by a large organizing effusion.…”

Comparison of closed-chest drainage with rib resection closed drainage for treatment of chronic tuberculous empyema

“…Tuberculous empyema is an infection of the pleural cavity by Mycobacterium tuberculosis that provokes the accumulation of purulent pleural fluid (20). Tuberculous empyema usually occurs in younger (21) middle-aged (22,23) patients.…”