Tuberculous pleurisy with effusion

Chih Jen Hsu, Kuan Jen Bai, I. Hsin Chiang, Ming Pin Wu, Tao Ping Lin, Sow Hsong Kuo

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

To assess the clinical features of Taiwanese patients with tuberculous pleurisy and their response to treatment, we analyzed the records of patients treated for this condition from December 1990 through November 1995, at a regional 100-bed referral center for tuberculosis care. Diagnosis of tuberculous pleurisy was based on histologic evidence of caseating granulomatous inflammation in the pleural biopsy specimen, or evidence of mycobacteria in pleural fluid. Patients were also stratified on the basis of parenchymal involvement. Ninety-seven patients (79 men, 18 women) with a mean age of 47.5 (range, 15-90) years were included in the analysis. The two major symptoms were cough (69%) and shortness of breath (57%). Chest roentgenographs showed that the pleural effusion was unilateral in 88 (91%) patients, and small to moderate in amount in 74 (76%). Laboratory analysis of the pleural fluid showed moderate levels of glucose (4.6 mmol/L), with no significant difference between patients with and without parenchymal involvement. The levels of lactate dehydrogenase and triglycerides were significantly higher in patients with parenchymal involvement (172 vs 240.5 IU and 0.36 vs 0.45 mmol/L, respectively). In 85 of 93 patients (91%) with available data, lymphocytes were predominant in the differential count. All patients had received short-course chemotherapy for at least 6 months. After excluding the defaulters and patients receiving subsequent management in other hospitals, the overall rate of successful treatment was 97% (72/74). There was no significant difference in the treatment outcome between patients with parenchymal involvement and those without. None of the successfully treated patients had a relapse within a mean follow-up period of 31.7 ± 18.4 months. We conclude that current patients with tuberculous pleurisy in Taiwan are not young, and short-course chemotherapy with isoniazid, ethambutol, rifampicin, and pyrazinamide is an effective treatment. The presence of parenchymal tuberculous lesions does not appear to influence the treatment outcome.

Original languageEnglish
Pages (from-to)678-682
Number of pages5
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume98
Issue number10
Publication statusPublished - Oct 1999
Externally publishedYes

    Fingerprint

Keywords

  • Parenchymal involvement
  • Treatment outcome
  • Tuberculous pleurisy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hsu, C. J., Bai, K. J., Chiang, I. H., Wu, M. P., Lin, T. P., & Kuo, S. H. (1999). Tuberculous pleurisy with effusion. Journal of the Formosan Medical Association = Taiwan yi zhi, 98(10), 678-682.