Clinicopathologic characteristics of pediatric tuberculous pleural effusion: a retrospective analysis of 112 consecutive cases.

Abstract

OBJECTIVE: The aim of this study was to describe the clinicopathologic characteristics of pediatric tuberculous pleural effusion (TPE) patients to make an accurate diagnosis. PATIENTS AND METHODS: Pediatric TPE patients who admitted to Shandong Provincial Chest Hospital were retrospectively reviewed from March 2006 to April 2015. RESULTS: 112 pediatric TPE patients were enrolled. The mean age was 11.6 ± 3.2 years. 60 (53.6%) patients were diagnosed as TPE, 40 (35.7%) were TPE+Pulmonary tuberculosis (PTB). 96 (85.7%) patients had fever (> 37°C), 81 (72.3%) had dyspnea, 63 (56.3%) had cough. Radiological test results showed effusions on the right side in 58 patients (51.8%), on the left side in 50 patients (44.6%), and on both sides in 4 patients (3.6%). 6 (5.4%) patients were acid-fast bacilli (AFB) smear-positive. 16 (14.3%) PCR positive patients were identified. 41 (36.6%) TB patients were culture-positive. Almost all effusions (99.1%) had the biologic characteristics of exudates. In 91.2% of the effusions, more than 50% of leukocytes were lymphocytes. Pleural adenosine deaminase (40 U/L) was positive in 74.5% of the patients, and erythrocyte sedimentation rate was raised in 84.1%. CONCLUSIONS: The usefulness of routine microbiological tests to diagnose pleural TB is limited by its poor sensitivity. Further studies should be performed to validate new techs and assays for pediatric TPE.