Synonyms
Tuberculous pleural effusion
Definition
It refers to an accumulation of serofibrinous fluid within the pleural space, usually occurring shortly after a primary tuberculous infection. Spread may occur directly through the visceral pleura from the pulmonary focus or from adjacent tuberculous hilar or mediastinal lymph nodes. Blood spread is the more likely cause when there are bilateral tuberculous pleural effusions. Alternate routes of spread are from the pericardium or pleural lymphatics. In developed countries, it may be a manifestation of reactivated infection. It is the second most common site of extrapulmonary tuberculosis (EPTB).
Clinical Features
Incidence
The incidence varies according to the degree of industrialization of the country. There are over 500,000 cases of tuberculous pleural effusion diagnosed annually worldwide.
Pleural TB occurs in 5% of TB cases in the USA; in Spain, 10–23%; in Malaysia, 10–12%; and in Turkey, 30%.
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Dheda, K., Van-Zyl Smit, R. N., Sechi, L. A., Badri, M., et al. (2009). Clinical diagnostic utility of IP-10 and LAM antigen levels for the diagnosis of tuberculous pleural effusions in a high burden setting. PLoS ONE, 4(3), e4689.
Gopi, A., Madhavan, S. M., Sharma, S. K., & Sahn, S. A. (2007). Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest, 131, 880–889.
Kumar, P., Sen, M. K., Chauhan, D. S., Katoch, V. M., et al. (2010). Assessment of the N-PCR assay in diagnosis of pleural tuberculosis : Detection of M.tuberculosis in pleural fluid & sputum collected in tandem. PLoS ONE, 5(4), e10220.
Nicol, M. P., & Wilkinson, R. J. (2008). The clinical consequences of strain diversity in Mycobacterium tuberculosis. Transactions of the Royal Society of Tropical Medicine and Hygiene, 102, 955–965.
Porcel, J. M. (2009). Tuberculous pleural effusion. Lung, 187, 263–270.
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Wainwright, H.C. (2018). Pleural Mycobacterial Infections. In: Allen, T.C., Suster, S. (eds) Pathology of the Pleura and Mediastinum. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-66796-6_807
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DOI: https://doi.org/10.1007/978-3-319-66796-6_807
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