Pleural Mycobacterial Infections
Tuberculous pleural effusion
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).
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%.
Coinfection with HIV has resulted in...