Tuberculous pleural effusion

被引:102
|
作者
Zhai, Kan
Lu, Yong
Shi, Huan-Zhong
机构
[1] Capital Med Univ, Beijing Inst Resp Med, Dept Resp & Crit Care Med, Beijing 100020, Peoples R China
[2] Capital Med Univ, Beijing Chaoyang Hosp, Beijing 100020, Peoples R China
关键词
Pleural effusion; tuberculous pleurisy; tuberculosis; HUMAN-IMMUNODEFICIENCY-VIRUS; DRUG-RESISTANT TUBERCULOSIS; ADENOSINE-DEAMINASE; INTERFERON-GAMMA; MEDICAL THORACOSCOPY; DIAGNOSTIC-VALUE; DOUBLE-BLIND; PULMONARY TUBERCULOSIS; INTERLEUKIN; 27; YIELD;
D O I
10.21037/jtd.2016.05.87
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Although it is curable, tuberculosis remains one of the most frequent causes of pleural effusions on a global scale, especially in developing countries. Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. TPE usually presents as an acute illness with fever, cough and pleuritic chest pain. The pleural fluid is an exudate that usually has predominantly lymphocytes. The gold standard for the diagnosis of TPE remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli, Although adenosine deaminase and interferon-gamma in pleural fluid have been documented to be useful tests for the diagnosis of TPE. It can be accepted that in areas with high tuberculosis prevalence, the easiest way to establish the diagnosis of TPE in a patient with a lymphocytic pleural effusion is to generally demonstrate a adenosine deaminase level above 40 U/L. The recommended treatment for TPE is a regimen with isoniazid, rifampin, and pyrazinamide for two months followed by four months of two drugs, isoniazid and rifampin.
引用
收藏
页码:E486 / E494
页数:9
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