Pleural Tuberculosis

Pleural tuberculosis (TB) is a major treatable cause of exudative pleural effusions. The frequency of pleural effusion in TB patients was approximately 31%. Pleural involvement may be primary, secondary to pulmonary TB (e.g., miliary TB) or post primary (reactivation) TB pleurisy. TB empayema is a chronic active pleural infection that is a more complicated form of the pleural TB. Clinical presentation of the pleural TB may be subtle or severe, with pleuritic chest pain, nonproductive cough, fever, dyspnea, night sweat and weight loss. Diagnostic tests include thoracocenthesis, sputum smear and culture, pleural biopsy, Tuberculostearic acid, ADA, PCR and d-INF. Pleural TB should be treated with standard anti-TB regimen. Thoracocenthesis is needed just for symptom relief and has no therapeutic effect. Corticosteroids, although may help in faster recovery, may cause pleural adhesions. For TB empayema, in addition to standard chemotherapy, surgical drainage is also mandatory.