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Yield of Sputum Induction in the Diagnosis of Pleural Tuberculosis
Abstract
We prospectively evaluated the diagnostic yield of acid-fast bacilli smear and culture for Mycobacterium tuberculosis using sputum induction (SI) in the workup of patients with suspected pleural tuberculosis (TB) who were unable to produce sputum spontaneously. Of the 113 patients studied, a final diagnosis of pleural TB was made in 84 patients (71 HIV seronegative) and a final diagnosis of another disease in 29 patients. Histopathologic examination of the pleural biopsy tissue had the highest diagnostic yield (78%; 66/84). The bacteriologic yield was 62% (52/84) for the pleural tissue, 12% (10/84) for pleural fluid, and 52% (44/84) for sputum cultures obtained by SI. The yield of SI culture for M. tuberculosis was 55% (35/64) in patients with a normal radiograph (except for the pleural effusion) and 45% (9/20) in those with evidence of parenchymal disease suggestive of pulmonary TB (p = 0.6). The yield of sputum cultures obtained by SI is high in patients suspected of having pleural TB even in those cases with no pulmonary parenchymal abnormalities on the chest radiograph.
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“In a prospective cohort study of participants with clinical and radiological findings consistent with pleural tuberculosis, Conde 2003 found that histological examination of tissue obtained from pleural biopsy had a higher diagnostic yield (78%; 66/84) than that of culture (62%; 52/84).”
From Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults (2021) · cites this paper as Conde 2003
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Diagnosis and Treatment of Extrapulmonary Tuberculosis
Lee, J. Y. (2015) · Tuberculosis & respiratory diseases · doi:10.4046/trd.2015.78.2.47 · Cited by 541
Zar, H. J., Hanslo, D., Apolles, P., Swingler, G. H., & Hussey, G. D. (2005) · The Lancet · doi:10.1016/s0140-6736(05)17702-2 · Cited by 508
Diagnosis and Treatment of Tuberculous Pleural Effusion in 2006
Gopi, A., Madhavan, S. M., Sharma, S. K., & Sahn, S. A. (2007) · CHEST Journal · doi:10.1378/chest.06-2063 · Cited by 486
Update on tuberculous pleural effusion
Light, R. W. (2010) · Respirology · doi:10.1111/j.1440-1843.2010.01723.x · Cited by 468
Porcel, J. M. (2009) · Lung · doi:10.1007/s00408-009-9165-3 · Cited by 303
Metadata
- Authors
- Conde, M. B., Loivos, A. C., Rezende, V. M., Soares, S. L. M., Mello, F. C. Q., Reingold, A. L., Daley, C. L., & Kritski, A. L.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Divisão de Tisiologia e Pneumologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil; School of Public Health, University of California, Berkeley; and Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, California
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-03-01
- Volume
- 167
- Issue
- 5
- Pages
- 723-725
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2069211273
- Cited by
- 204
- References
- 12
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 14 · 2020: 8 · 2019: 13 · 2018: 15 · 2017: 11 · 2016: 13 · 2015: 14 · 2014: 10 · 2013: 7 · 2012: 7
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fogarty International Center (TW0004, D43TW000004)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Keywords
- pleural tuberculosis, sputum induction, Mycobacterium tuberculosis, acid-fast bacilli smear, bacterial culture, diagnostic yield, pleural biopsy, pleural fluid, HIV-negative patients, pulmonary tuberculosis
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Data Interpretation, Statistical, Diagnostic Techniques, Respiratory System, Female, HIV Seropositivity, Humans, Male, Middle Aged, Mycobacterium tuberculosis, Pleura, Pleural Effusion, Prospective Studies, Sputum, Radiography, Thoracic, Tuberculosis, Pleural, Chi-Square Distribution, HIV Seronegativity
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