Sarker Z M, Mahmud A K, Chowdhury A J, Hasnat M A, Alam M R, Paul H K, Bhuiyan M R
Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jan;20(1):66-70.
Despite prevention programs, tuberculosis is still endemic in developing countries. Extrapulmonary tuberculosis is increasing globally in the face of recent emergence of Human Immunodeficiency Virus (HIV) infection. Pleural tuberculosis is a common problem in daily clinical practice. We assessed 26 cases of tuberculous pleural effusion admitted in Bangabandhu Sheikh Mujib Medical University from 2002 to 2007. The diagnosis was based upon clinical examination, tuberculin reaction, imaging, pleural fluid analysis and response to antitubercular chemotherapy a surrogate clinical determinant. Apparently promising newer biochemical pleural fluid measurements were not utilized due to a number of limitations. The presenting symptoms found in this prospective analysis are fever (100%), nonproductive cough (73%), pleuritic chest pain (38%), loss of weight (38%) and shortness of breath (38%). A high index of suspicion after confident exclusion of malignancy and pneumonia is a clue to diagnosis. Out of 80 cases of extrapulmonary tuberculosis admitted during the study period, tuberculous pleural effusion constitutes 32.50%.
尽管有预防项目，但结核病在发展中国家仍然流行。面对近期出现的人类免疫缺陷病毒（HIV）感染，肺外结核病在全球范围内呈上升趋势。结核性胸膜炎是日常临床实践中的常见问题。我们评估了2002年至2007年在孟加拉国谢赫穆吉布医科大学收治的26例结核性胸腔积液病例。诊断基于临床检查、结核菌素反应、影像学检查、胸腔积液分析以及对抗结核化疗的反应（一种替代临床决定因素）。由于一些局限性，未采用明显有前景的新型胸腔积液生化检测方法。在这项前瞻性分析中发现的主要症状有发热（100%）、干咳（73%）、胸膜炎性胸痛（38%）、体重减轻（38%）和呼吸急促（38%）。在自信地排除恶性肿瘤和肺炎后高度怀疑是诊断的线索。在研究期间收治的80例肺外结核病病例中，结核性胸腔积液占32.50%。
