ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Infectiousness of pleural tuberculosis without radiological evidence for parenchymal involvement
Ersin Demirer1, Erdoğan Kunter1, Ahmet İlvan1, Hakan Çermik2, Hakan Mutlu3, Faruk Çiftçi1
1Departments of Pulmonary Diseases, GATA Haydarpaşa Training Hospital, İstanbul
2Departments of Pathology, GATA Haydarpaşa Training Hospital, İstanbul
3Departments of Radiology, GATA Haydarpaşa Training Hospital, İstanbul
Background: Pleural tuberculosis is not always associated with radiologically evident parenchymal disease (PD) and, in clinical practice, patients without radiological evidence for PD are usually deemed noninfectious.

Methods: The study included 77 patients (3 females, 74 males; mean age 23±6 years; range 18 to 52 years) with a definite diagnosis of pleural tuberculosis. Patients with a positive sputum smear or gastric lavage smear for acidfast bacilli and/or positive sputum culture or gastric lavage culture for M. tuberculosis were considered possibly infectious.

Results: When sputum and gastric lavage results were taken together, smear positivity was found in six (7.8%) and culture positivity was found in 21 cases (27.3%). Overall, 21 patients (27.3%) had bacillus-positive pulmonary tuberculosis. Chest X-ray revealed PD in 29 patients (37.7%). Highresolution computed tomography (HRCT) was performed in 55 patients and PD was found in 48 patients (87.3%). Of the patients with PD on chest radiograms, five (17.2%) had positive smears and 13 (44.8%) had positive cultures of sputum or gastric lavage. Of 48 patients without PD on chest radiograms, one (2.1%) had smear positivity and eight (16.7%) had culture positivity. Sputum or gastric lavage samples showed one smear positivity (2.1%) and 12 culture positivity (25%) among 48 patients who were found to have PD by HRCT. Of seven cases in which HRCT did not show PD, two (28.5%) had positive cultures and none had positive smears. Although HRCT was more sensitive to detect PD, infectiousness rate was significantly higher in patients who had PD on chest radiograms (p=0.007).

Conclusion: We suggest that pleural tuberculosis cases may be infectious despite lack of radiological evidence for parenchymal involvement.

Keywords : Bronchoalveolar lavage fluid/microbiology; pleura/microbiology; sputum/microbiology; tomography, x-ray computed; tuberculosis, pleural/diagnosis/radiography
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