Publicação

Tuberculose pleural : a propósito de um caso clínico

Detalhes bibliográficos
Resumo:	Pleural Tuberculosis is a disease associated with the Mycobacterium tuberculosis infection that should be considered in every patient with an undiagnosed pleural effusion. The clinical presentation is nonspecific. The identification of mycobacteria in the pleural fluid and /or pleural tissue is the gold standard for the diagnosis. A presumptive diagnosis can be made by the identification of an exudate with predominance of lymphocytes in the pleural fluid and a granulomatous inflammatory process in the pleural tissue histopathology. Biological markers - adenosine deaminase and interferon γ - are also useful for establishing the diagnosis. Although the infection usually resolves spontaneously, the treatment with antituberculostatic chemotherapy is crucial to prevent recurrences. This paper presents the case of a 42 years old patient with a pleural effusion of undetermined etiology. A thoracoscopy with biopsy of the pleural tissue was performed. The analysis of the pleural fluid revealed an exudate with predominance of lymphocytic cells and elevated levels of adenosine deaminase. Quadruple antituberculostatic empiric therapy was initiated after the identification of acid-fast bacilli on a smear of the pleural tissue. The definitive etiologic diagnosis was established after the identification of the Mycobacterium tuberculosis in the cultural exam of the pleural tissue.
Autores principais:	Vassalo, Tânia Cristina Pina
Assunto:	Tuberculose pleural Tuberculose extrapulmonar Derrame pleural Terapêutica antituberculostática Vírus da imunodeficiência humana Marcadores biológicos
Ano:	2014
País:	Portugal
Tipo de documento:	dissertação de mestrado
Tipo de acesso:	acesso restrito
Instituição associada:	Universidade de Lisboa
Idioma:	português
Origem:	Repositório da Universidade de Lisboa

Descrição
Resumo:	Pleural Tuberculosis is a disease associated with the Mycobacterium tuberculosis infection that should be considered in every patient with an undiagnosed pleural effusion. The clinical presentation is nonspecific. The identification of mycobacteria in the pleural fluid and /or pleural tissue is the gold standard for the diagnosis. A presumptive diagnosis can be made by the identification of an exudate with predominance of lymphocytes in the pleural fluid and a granulomatous inflammatory process in the pleural tissue histopathology. Biological markers - adenosine deaminase and interferon γ - are also useful for establishing the diagnosis. Although the infection usually resolves spontaneously, the treatment with antituberculostatic chemotherapy is crucial to prevent recurrences. This paper presents the case of a 42 years old patient with a pleural effusion of undetermined etiology. A thoracoscopy with biopsy of the pleural tissue was performed. The analysis of the pleural fluid revealed an exudate with predominance of lymphocytic cells and elevated levels of adenosine deaminase. Quadruple antituberculostatic empiric therapy was initiated after the identification of acid-fast bacilli on a smear of the pleural tissue. The definitive etiologic diagnosis was established after the identification of the Mycobacterium tuberculosis in the cultural exam of the pleural tissue.