Abstract

Aim: The aim of this study is to show the diagnostic difficulties and importance of various methods for diagnosis of tuberculous pleurisy. Material and methods: In this retrospective study we analyzed patients with tuberculous pleurisy treated in Clinic for pulmonary diseases and TB “Podhrastovi” in four-year period from 2011. to 2014. , and methods used for establishing diagnosis. In all patients sputum and pleural effusion sample obtained by pleural punctuation were examined for Mycobacterium tuberculosis: microscopically and culturally (liquid culture media). Pleural tissue biopsy using Abram’s needle was done in 19 patients. All so obtained samples were histological examined, and 10 were bacteriological examined for Mycobacterium tuberculosis. Results: In this four year period 45 patients, or 11.08% of all patients with tuberculosis, were treated in Clinic “Podhrastovi”. Microscopic and cultural examination for Mycobacterium tuberculosis of sputum was positive only in patients with pleural form associated with pulmonary form of tuberculosis. Examination of pleural fluid by liquid culture media was positive in 40 (88.89%) patients. In 9 of 10 patients (90%) Mycobacterium tuberculosis was found by cultural examination in biopsied pleural tissue. In 19 patients (100%) tuberculous granulomas were found in biopsied pleural tissue. Conclusion: The most sensitive diagnostic methods for diagnosis of tuberculous pleurisy is the Mycobacterium tuberculosis cultural examination of pleural fluid and pleural biopsied tissue and histological examination of pleural biopsied tissue with 90-100% positive results.

Key words: tuberculosis, pleurisy, diagnostics.