N O Touré1, M Wayzani2, K Thiam1, M F Cissé1, F B Mbaye1. 1. Service de pneumologie, Centre hospitalier national universitaire de Fann, 60, rue Abdou Karim Bourgie, 1657 Dakar, Sénégal. 2. Service de pneumologie, Centre hospitalier national universitaire de Fann, 60, rue Abdou Karim Bourgie, 1657 Dakar, Sénégal. Electronic address: mehdyway@hotmail.com.
Abstract
INTRODUCTION: Performance of the Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in pleural liquid is poorly described. The aim of this study was to determine its usefulness for the etiological diagnosis of a tuberculous pleurisy. PATIENTS AND METHOD: We performed a descriptive cross-sectional study, with analytical design, including all the patients having a unilateral serofibrinous pleurisy, exudative, lymphocytic, and sterile. The diagnosis of pleural tuberculosis was considered based on epidemiological, clinical, paraclinical and therapeutic arguments. The Xpert MTB/RIF of the pleural fluid was carried out among all patients. RESULTS: Pleural tuberculosis was confirmed in 301 patients. The median age was 32years. Our study has included 217 men (72.1%) with a final sex ratio of 2.6. The cost of the pleural biopsy coupled with histology made it practicable in only 90 patients (29.9%) with a yield of 80%. The Xpert MTB/RIF of the pleural liquid was positive in only 10 patients (3.3% of the cases). CONCLUSION: Gene amplification by Xpert MTB/RIF of the pleural liquid is much less effective in establishing the diagnosis of tuberculous pleurisy than pleural biopsy, which remains the gold standard.
INTRODUCTION: Performance of the Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in pleural liquid is poorly described. The aim of this study was to determine its usefulness for the etiological diagnosis of a tuberculous pleurisy. PATIENTS AND METHOD: We performed a descriptive cross-sectional study, with analytical design, including all the patients having a unilateral serofibrinous pleurisy, exudative, lymphocytic, and sterile. The diagnosis of pleural tuberculosis was considered based on epidemiological, clinical, paraclinical and therapeutic arguments. The Xpert MTB/RIF of the pleural fluid was carried out among all patients. RESULTS:Pleural tuberculosis was confirmed in 301 patients. The median age was 32years. Our study has included 217 men (72.1%) with a final sex ratio of 2.6. The cost of the pleural biopsy coupled with histology made it practicable in only 90 patients (29.9%) with a yield of 80%. The Xpert MTB/RIF of the pleural liquid was positive in only 10 patients (3.3% of the cases). CONCLUSION: Gene amplification by Xpert MTB/RIF of the pleural liquid is much less effective in establishing the diagnosis of tuberculous pleurisy than pleural biopsy, which remains the gold standard.
Authors: Mikashmi Kohli; Ian Schiller; Nandini Dendukuri; Keertan Dheda; Claudia M Denkinger; Samuel G Schumacher; Karen R Steingart Journal: Cochrane Database Syst Rev Date: 2018-08-27