ABSTRACT
Tuberculous pleuritis has increased worldwide, especially in developing countries,
as a consequence of human immunodeficiency virus co-infection. Tuberculous pleuritis
is a delayed hypersensitivity reaction against mycobacterial antigens in the pleural
space. Mycobacteria are detected in less than 50% of pleural samples, but the characteristic
pleural involvement, granulomas with or without caseous necrosis, is evident in 56
to 80% of cases from samples obtained by percutaneous pleural biopsy. Of several pleural
fluid parameters studied, adenosine deaminase and interferon gamma (IFN-γ) have the
best diagnostic yield, while polymerase chain reaction remains a promising test. Treatment
of patients with tuberculous pleuritis is discussed.
Tuberculous empyema is a rare form of tuberculous pleuritis. It consists of a purulent
infection of the pleural cavity with detectable bacilli in pleural fluid. Diagnosis
is easily established clinically and bacteriologically. Treatment is to adequately
drain the pleural space and achieve lung reexpansion, in conjunction with antituberculous
chemotherapy. The efficacy of different surgical techniques is discussed.
KEYWORD
Tuberculous pleuritis - tuberculous empyema - diagnosis - treatment
