Improved diagnosis of pleural tuberculosis using the microscopic- observation drug-susceptibility technique.

Tests for pleural tuberculosis are insensitive and expensive. We compared nonproprietary microscopic-observation drug-susceptibility (MODS) culture with Löwenstein-Jensen culture for evaluation of pleural specimens. MODS culture was associated with greatly increased diagnostic sensitivity and shorter time to diagnosis, compared with Löwenstein-Jensen culture (sensitivity of culture of biopsy specimens, 81% vs.51%; time to diagnosis, 11 days vs. 24 days; P < .001). The MODS technique is inexpensive, allows drug-susceptibility testing, and is a considerably improved diagnostic method for pleural tuberculosis.

[1]  S. Sahn,et al.  Diagnosis and treatment of tuberculous pleural effusion in 2006. , 2007, Chest.

[2]  N. Saravia,et al.  Evaluation of polymerase chain reaction, adenosine deaminase, and interferon-gamma in pleural fluid for the differential diagnosis of pleural tuberculosis. , 2000, Chest.

[3]  D. Enarson,et al.  Tuberculous pleurisy. , 1982, Canadian Medical Association journal.

[4]  A. R. Escombe,et al.  Microscopic-Observation Drug-Susceptibility Assay for the Diagnosis of TB , 2008 .

[5]  S. Jindal,et al.  Evaluation of polymerase chain reaction for detection of Mycobacterium tuberculosis in pleural fluid. , 2001, Chest.

[6]  G. Maartens,et al.  A comparative study of the polymerase chain reaction and conventional procedures for the diagnosis of tuberculous pleural effusion. , 1992, Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[7]  J. Curtis,et al.  Rapid diagnosis of pleural tuberculosis by polymerase chain reaction. , 1996, American journal of respiratory and critical care medicine.

[8]  Darshak M Sanghavi,et al.  Hyperendemic pulmonary tuberculosis in a Peruvian shantytown. , 1998, American journal of epidemiology.

[9]  A. R. Escombe,et al.  Tuberculosis mortality, drug resistance, and infectiousness in patients with and without HIV infection in Peru. , 2006, The American journal of tropical medicine and hygiene.

[10]  C. Kirsch,et al.  The optimal number of pleural biopsy specimens for a diagnosis of tuberculous pleurisy. , 1997, Chest.

[11]  G. Maartens,et al.  Tuberculous pleural effusions: increased culture yield with bedside inoculation of pleural fluid and poor diagnostic value of adenosine deaminase. , 1991, Thorax.

[12]  L. Valdés,et al.  Tuberculous pleurisy: a study of 254 patients. , 1998, Archives of internal medicine.