Korean J Med.
2011 Aug;81(2):150-153.
Diagnosis and Treatment of Tuberculous Pleuritis
- Affiliations
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- 1Division of Pulmonary and Critical Care Medicine, Depatment of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea. yimjj@snu.ac.kr
Abstract
- Tuberculous (TB) pleuritis is the second most common form of extrapulmonary tuberculosis. Because the yield of pleural fluid mycobacterial culture is as low as 20% and the pleural biopsy is rather invasive, the measurement of adenosine deaminase (ADA) has been a cornerstone of the diagnosis of TB pleuritis. If the ADA level of pleural fluid is higher than 70 IU/L, the diagnosis of TB pleuritis can be made safely. The treatment is based on a standard short course anti-TB treatment starting with isoniazid, rifampicin, ethambutol, and pyrazinamide. Although systemic steroids and drainage of pleural fluid have been tried to reduce the residual pleural thickening, the results are contradicting.
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