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Utility of pleural fluid routine and microscopy examination plus adenosine deaminase levels in the diagnosis of tuberculous pleural effusion

Gunjan P Upadhyay, Rameshchandra M Thakker.

Background: Tuberculous pleural effusion is the second most common site of extrapulmonary tuberculosis. Not all centers have access to advanced and invasive tests and affordability is also an issue. Hence, diagnosis is largely based on history, clinical examination, and pleural fluid analysis.

Objectives: Our aim was to evaluate the utility of pleural fluid routine micro examination along with adenosine deaminase (ADA) levels in diagnosis of tuberculous pleural effusion.

Materials and Methods: A retrospective analysis was done of the 100 adult patients with pleural effusion predefined criteria were adopted to label a case as tuberculous. Using MS Excel 2007 sensitivity, specificity, positive and negative likelihood ratio, accuracy, etc., were derived and various parameters in pleural fluid were also studied.

Result: The sensitivity, specificity, positive, and negative predictive values, positive and negative likelihood ratios, accuracy, and discordance were 95.74%, 94.33%, 93.75%, 96.15%, 16.88%, 4.51%, 95%, and 5%, respectively.

Conclusion: Pleural fluid routine micro examination along with ADA levels has an acceptable sensitivity, specificity, and accuracy for the diagnosis of tuberculous pleural effusion.

Key words: Pleural Effusion; Adenosine Deaminase; Tuberculosis

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Journal of Apitherapy


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