Mycobacterial Infections, Pleura

Definition

Mycobacterial infections of the pleura occur when mycobacterial organisms enter the pleural space. Mycobacterium tuberculosis is the most common cause of mycobacterial pleural infection. Pleural infections with other mycobacterial organisms such as Mycobacterium avium-intracellulare have been described but are rare. Unlike bacterial infections of the pleura, which may spread to pleural effusions from parenchymal lung infections like pneumonia, mycobacteria require breach of the pleura to enter the pleural space. Tuberculous pleuritis most likely occurs secondary to rupture of a peripheral focus of pulmonary tuberculosis.

Historically, tuberculosis was a major cause of pleural infection; however, since the advent of anti-tuberculin drugs, the incidence of tuberculous pleuritis has greatly decreased in the western world. It is still a significant problem in developing countries. Furthermore, in recent years, due to the AIDS epidemic and due to the increase in immunocompromised...