ETIOLOGICAL VERIFICATION OF TUBERCULOUS PLEURISY IN HIV INFECTED PATIENTS

Abstract

As much as 102 new TB cases with pleurisy were studied. Average age was 31,5 years, 88 (86,3%) patients had TB/HIV coinfection. In 57 (55,9%) cases pleura was the only site of active TB, in the remaining cases other locations of active TB were also detected. TB origin of pleurisy was approved with exudates culture for Mycobacterium TB positive in each third case and with exudates positive for Mycobacterium TB complex DNA in 68,6% cases. Sensitivity of polymerase chain reaction (PCR) in pleural fluid was higher in TB/HIV patients. Direct TB affection of the pleura is the leading reason of tuberculous pleural effusion in HIV infected patients. All possible diagnostic tools should be used simultaneously to approve the origin of TB pleurisy. Regarding diagnostics of pleurisy, PCR of pleural fluid should be considered as the priority method, especially in patients with HIV-infection. Thoracoscopy with pleural biopsy increases the diagnostic potential of etiological verification of TB pleurisy.