Observation of efficacy of central venous catheter in combination with pleural lavage in the treatment of tuberculous pleuritis
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[21.] Baba K, Hoosen AA, Langeland N, Dyrhol-Riise A (2008) Adenosine deaminase activityis a sensitive marker for the diagnosis of tuberculous pleuritis
in patients with very low CD4 counts.
Comparison of six biological markers for the diagnosis of tuberculous pleuritis
. Chest 2004; 125:987-989.
Interpretation & conclusions: Our findings demonstrated that the decreased leptin levels were associated with reduction in BMI but not with the disease status in tuberculous pleuritis.
Hence, as an extension of these studies, we conducted the present study of assessing leptin levels at the site of infection (ie pleural fluid) using tuberculous pleuritis as a model.
In one study of 248 patients with tuberculous pleuritis
who underwent needle biopsy of the pleura, the biopsy showed granulomas in 198 patients (80%), the acid-fast stain of the biopsy was positive in 64 (25.8%), the culture of the biopsy tissue was positive in 140 (56%) and at least one of the preceding three tests was positive in 227 (91%).
(5.) Light RW, Establishing the diagnosis of tuberculous pleuritis
. Arch Intern Med 1998;158(18):1967-8.
Characteristics of patients suffering from tuberculous pleuritis
with pleural effusion, culture positive and negative for Mycobacterium tuberculosis and risk factors for fatality.
Several studies have shown that ADA activity, especially when combined with differential leucocyte count and lymphocyte/neutrophil ratio in pleural fluid remain a useful test in the diagnosis of tuberculous pleuritis
. When the lymphocyte to neutrophils ratio (L/N ratio) >0.75 in pleural fluid was considered together with ADA activity >50IU/L, the results improved considerably for the diagnosis of tubercular pleuritis.
The demonstration of granulomas in an exudative pleural effusion is an adequate evidence for the diagnosis of tuberculous pleuritis
, since the vast majority of patients (more than 95%) with granulomatous pleuritis have tuberculosis.
Pleural fluid adenosine deaminase (ADA) level of >70 U/L was diagnostic of tuberculous pleuritis
while level <40 U/L virtually ruled out this diagnosis.
C-reactive protein in lymphocytic pleural effusions: A diagnostic aid in tuberculous pleuritis
. Respiration 2005; 72: 486-9.