[Etiologies of pleurisies in African milieu. Experience of the Cocody Pneumology department (Abidjan-Côte d'Ivoire)].

We analyzed hospital files of 614 pleurisy patients at the Cocody University Hospital over a 5 year period (1990-1994). We searched for the main etiologies of pleural effusion in these patients in order to propose an empirical treatment. Pleurisy is involved in 23% of all respiratory patients seen each year. Pleural effusions are observed in 91% of the cases. Clear fluid was observed most frequently (65%), followed by purulent (31%) and hemorrhagic effusion (4%). The dominant etiology was tuberculosis (66%). Non-tuberculosis infections were found in 5% of the cases. Tumoral diseases were involved in 3% and ambiasis in 1%. The cause of the pleural effusion remained unidentified in 24%. In 59% of the cases treatment was initiated without a definitive diagnosis. The incidence of HIV infection was high: 167 seropositive patients (72%) among the 231 patients tested. In conclusion, infections are the predominant etiologies of pleurisy at the Cocody University Hospital (72%) and the high frequency of tuberculosis argues for empirical antituberculosis therapy if no cause is identified.