Pulmonary involvement in pleural tuberculosis: How often does it mean disease activity?

• Published in: Respiratory medicine 2011-07, Vol.105 (7), p.1079-1083
• Main Authors: Seiscento, Márcia, Vargas, Francisco S, Bombarda, Sidney, Sales, Roberta K.B, Terra, Ricardo M, Uezumi, Kiyomi, Teixeira, Lisete R, Antonangelo, Leila
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Chest X-ray; Computed tomography; Consolidation; Disease; Female; Human bacterial diseases; Human immunodeficiency virus; Humans; Infectious diseases; Lung - diagnostic imaging; Lung - physiopathology; Male; Medical diagnosis; Medical sciences; Middle Aged; Mycobacterium; Pleural Diseases - diagnostic imaging; Pleural Diseases - physiopathology; Pleural effusion; Pneumology; Prospective Studies; Pulmonary/Respiratory; Respiratory system : syndromes and miscellaneous diseases; Tomography, X-Ray Computed - methods; Tuberculosis; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Pleural - diagnostic imaging; Tuberculosis, Pleural - physiopathology; Young Adult
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2011.02.014

Summary Objective To evaluate in chest X-rays and high-resolution computed tomographies of patients with pleural tuberculosis, the incidence of parenchymal and mediastinal lung lesions suggestive of active disease. Methods Prospective study (2008–2009) evaluating the radiographic and tomographic abnormalities of 88 HIV-negative patients with pleural tuberculosis (unilateral effusion). The images were reviewed by 3 independent specialists, and the observed changes were classified according to previously established criteria: presence or absence of signs suggestive of disease activity, and nonspecific findings. Results Abnormal changes were observed in chest X-rays of 22 (25%) patients and in the computed tomography of 55 (63%). Images compatible with active pulmonary tuberculosis were detected by radiography in 9 (10%) patients and by tomography in 38 (43%). Only 4 (4.5%) patients had tomography images suggestive of residual disease. Conclusion The present study demonstrates that pulmonary involvement is quite common in pleural tuberculosis. This finding is mainly observed in high-resolution computed tomography and has important epidemiological implications, since patients with pleural tuberculosis are significant sources of infection and disease dissemination.