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Diagnostic Yield of Mycobacterium in Tuberculous Pleural Effusions: Comparision of Pleural Specimens Obtained By Closed Method With Thoracoscopy

Army Hospital (R & R), New Delhi, India

PURPOSE: To assess the value of closed pleural method versus thoracoscopy in bacteriological diagnosis of tuberculous pleural effusions.

METHODS: 100ml of pleural fluid and 5 pleural biopsy specimens each obtained by closed Abrahams punch pleural biopsy followed by medical thoracoscopy in 50 consecutive cases of tuberculous pleural effusions were examined separately for mycobacterium tuberculosis by direct smear and culture.The specimens obtained by thoracoscopy were under vision from areas of interest.

RESULTS: The positive smear and or culture for tuberculosis in pleural fluid and biopsy specimens obtained through Abrahams punch biopsy technique in tuberculous pleural effusions were 21 (42%) and 17 (34%) of cases respectively.In comparision specimens obtained through thoracoscopy yielded confirmation in 36 (72%) and 29 (58%) of cases respectively.

CONCLUSION: The chance of obtaining mycobacterium containing pleural specimens in tuberculous pleural effusion is much higher with medical thoracoscopy as compared with closed pleural biopsy technique.

CLINICAL IMPLICATION: Medical thoracoscopy is far superior to closed pleural method in obtaining pleural specimens for bacteriological confirmation of tuberculous pleural effusions.

DISCLOSURE: M.B. Prasad, None.