To determine the age at which tuberculous pleural effusions occur, the radiological and biochemical characteristics of the effusions, the sensitivities of the various diagnostic tests, and the utility of combining clinical, radiological, and analytic data in diagnosis.
We studied the case histories of 254 patients in whom tuberculous pleural effusions were diagnosed with certainty between January 1,1989, and June 30,1997, in a Spanish university hospital in a region with a high incidence of tuberculosis.
The mean (±SD) age of the patients was 34.1 ± 18.1 years, and 62.2% were younger than 35 years.
The effusion was on the right side in 55.9% of patients, on the left side in 42.5% of patients, and on both sides in 1.6% of patients.
In 81.5% of patients, less than two thirds of the hemithorax was affected.
Associated pulmonary lesions were detected in 18.9% of patients, of whom 14.6% exhibited cavitation.
In 93.3% of the effusions, more than 50% of leukocytes were lymphocytes, and almost all had the biologic characteristics of exudates (98.8% had high total protein contents, 94.9% had high cholesterol levels, and 82.3% had high lactate dehydrogenase levels).
All but 1 effusion (99.6%) had an adenosine deaminase (ADA) concentration higher than 47 U/L, 96.8% (123/127) of the effusions had high ADA2 levels, and 89% (73/82) of the effusions had high interferon gamma levels.
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Plèvre, Exploration clinique, Critère âge, Diagnostic, Analyse biochimique, Radiographie, Etude cas, Homme, Espagne, Europe, Appareil respiratoire pathologie, Plèvre pathologie, Radiodiagnostic
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Pleura, Clinical investigation, Age criterion, Diagnosis, Biochemical analysis, Radiography, Case study, Human, Spain, Europe, Respiratory disease, Pleural disease, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0488898
Code Inist : 002B11D. Création : 19/02/1999.