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Hong, Lim, Shin, and Park: Tuberculous Pleurisy: Clinical Characteristics of Primary and Reactivation Disease
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(6): 526-532.

Published online: 30 December 2006

DOI: https://doi.org/10.4046/trd.2006.61.6.526

Tuberculous Pleurisy: Clinical Characteristics of Primary and Reactivation Disease

Koo Hyun Hong, M.D., Sang Soo Lim, M.D., Jae Min Shin, M.D., Jae Seuk Park, M.D.

Department of Internal Medicine, College of Medicine, Dankook University, Chonan, Korea.

Address for correspondence: Jae Seuk Park, M.D. Department of Internal Medicine, Dankook University, College of Medicine, 16-5, Anseo-dong Chonan, 330-715, Korea. Phone: 041-550-3055, Fax: 041-556-3256, jspark@dankook.ac.kr

Received 13 October 2006       Accepted 11 December 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Traditionally, tuberculous pleurisy has been known to largely develop as primary tuberculosis. However, as the incidence of tuberculosis decrease, recent studies have shown reactivation tuberculosis has become the main cause of tuberculous pleurisy.

Methods

141 cases of tuberculous pleurisy, between January 2003 and February 2006, at the Dankook university hospital. were retrospectively studied. The patients were divided into primary and reactivation tuberculosis. based on the history and radiological characteristics, and the clinical, radiological characteristics at the time of diagnosis and residual pleural thickening after 6 month of chemotherapy were compared between the two groups.

Results

1. Of the 141 tuberculous pleurisy cases, in 135 it was possible to differentiate between primary and reactivation tuberculosis.
2. Of the 135 tuberculous pleurisy cases, 38 (28%) showed a primary tuberculosis pattern, and 98 (72%) showed a reactivation tuberculosis pattern.
3. There were no significant differences between primary and reactivation tuberculosis in relation to age, sex, duration of symptom, amount of pleural effusion, pleural fluid WBC, lymphocyte count, and level of protein, LDH and ADA at the time of diagnosis
4. 124 patients were followed for 6 months after diagnosis of tuberculous pleurisy, and there was no significant difference in the residual pleural thickening between primary and reactivation tuberculosis.

Conclusion

In South Korea, a reactivation disease is currently a more common cause of tuberculous pleurisy than a primary disease. There was no difference in the clinical characteristics between primary and reactivation tuberculosis.

Keywords: Tuberculous pleurisy, Primary, Reactivation

Figures and Tables

Figure 1
Percentage of patients according to age in both primary and reactivation tuberculosis.
trd-61-526-g001
Figure 2
Percentage of patients according to residual pleural thickening in both primary and reactivation tuberculosis. Residual pleural thickness was measured in the lower lateral hemithorax of a posteroanterior chest radiograph at the level of an imaginary line intersecting the diaphragm dome.
trd-61-526-g002
Table 1
Demographic and clinical characteristics of patients with primary and reactivation tuberculosis
trd-61-526-i001

Data are presented as mean ± SD unless otherwise indicated. *Duration between respiratory symptom onset to pleural tapping for diagnosis, †Estimated amount of pleural effusion in involved hemithorax, ‡Positive smear or culture findings from pleural fluid, No./total (%)

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