TUBERCULOUS PLEURISY – DIAGNOSTIC YIELDS OF PLEURAL FLUID MYCOBACTERIAL SMEAR AND CULTURE

Abstract

Abstract

Background:  Worldwide, Tuberculosis is a common etiological factor of exudative predominantly lympho-cytic effusions. Amongst extra-pulmonary manifestat-ions of tuberculosis, pleurisy is the second frequent manifestation. Detection of Mycobacterium tuberculo-sis by any means is the gold standard for establishing the diagnosis of tuberculosis.

Objective:  The purpose of the study was to determine the yield of mycobacterial smear and culture in exude-tive predominantly lymphocytic effusions.

Methodology:  This study was conducted on 100 (Male 65 / Female 35) cases with age range 13 to 69 years for the demonstration of Mycobacterium tuber-culosis in exudative predominantly lymphocytic ple-

Ch. M.K.¹

Associate Professor, Department of TB and Chest Medicine

KEMU / Mayo Hospital, Lahore

 Saeed M.S.²

Chairman Department of TB and Chest Medicine

KEMU / Mayo Hospital, Lahore

 Iqbal R.³

Director, PMRC, KEMU / Mayo Hospital, Lahore

 Hassan S.⁴

Registrar, Department of TB and Chest Medicine

Mayo Hospital, Lahore

ural effusions. The Mycobacterium smear was perfor-med by Zeihl Nelsen staining and culture on Lowen-stein Jensen medium.

Results:  Study results showed 1.02% (1 female case) Mycobacterium smear positivity and 2.04% (male 1 & female 1) culture positivity. Contamination was detec-ted in 2% (2 female cases) specimens. As concerned of fluid cytology, 85% of study cases had lymphocytosis between 85 - 95%. Remaining 15% cases had lympho-cytosis between 60 - 79%.

Conclusion:  Although detection of Mycobacterium either by smear or culture on any specimen is a gold standard for the diagnosis of TB but the yield of Mycobacterium in pleural fluid is very low. So other advanced techniques should be used to confirm the diagnosis of tuberculous pleurisy.

Key Words:  Mycobacterium tuberculosis, Ziehl Nel-sen staining, Lowenstein Jensen medium, Exudative lymphocytic pleural effusion.