Chest
Clinical InvestigationsTuberculous Pleural Effusion: Twenty-Year Experience
Section snippets
Methods
The Public Health Department of the State of Alabama maintains a state registry of patients with mycobacterial disease. Alabama statutes require that all cases of proven or suspected tuberculosis be reported to the Health Department, where they are reviewed or managed by a tuberculosis control physician. All dispensation of antimycobacterial drugs by private pharmacies must also be reported to the Health Department for case investigation. While these statutes are not strictly enforced,
Results
Seventy cases of tuberculous pleural effusion were identified, which represented 4.9 percent of all forms of disease due to M tuberculosis during this 20-year period. The 70 patients consisted of 47 men (mean age, 51 ± 17.1 years), and 23 women (mean age, 39 ± 17.7 years). The mean age of all patients was 47 ± 18.4 years (mean ± SD).
Roentgenographic, skin test, and culture data are tabulated in Table 1. All patients had a chest roentgenogram and at least three mycobacterial sputum cultures.
Discussion
Tuberculous pleural effusion was described in the literature of the mid-20th century as a sequel to recent infection occurring almost exclusively in children and young adults. As early as 1973, Berger and Mejia's series10 suggested that the average age of patients with tuberculous pleural effusion was increasing. This observation was repeated 14 years later when Epstein et al9 described 26 patients with tuberculous pleural effusion with a mean age of 56. Our series also demonstrates that the
Acknowledgments
The authors thank Sandy Mead for secretarial assistance and the staff at the Division of Tuberculosis Control, Mobile County Board of Health.
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Manuscript received August 13; revision accepted September 24.