| Abstract: |
Pleural tuberculosis (TB) is a diagnostic challenge because ofits nonspecific clinical presentation and paucibacillary nature, bysmear & Z-N stain, culture, and polynucleotide chain reaction (peR).The inefficiency of conventional laboratory methods (Z·Nsmear and culture) and the expensive and sophisticated test of PCR,have motivated the evaluation of alternative diagnostic strategies.Hence, the most likely pathogenetic mechanism ofpleural IB isessentially immunologic, we thought of immunologic studies in thediagnosis of tuberculous pleural effusion. These tests included PPDskin reactivity testing, lymphocyte proportion and level of adeninedeaminase (ADA) enzyme activity in pleural fluid.The study was conducted on 70 children suffering pleuraleffusions. Their ages ranged from 1 to 16 years old (mean age 9.35years), 42 were males and 28 were females.All children were subjected to1- History taking with special stress on; contact with a tuberculousadult, BCG·vaccination; and symptoms including fever, nightsweats, anorexia, weight loss, cough with or without expectoration,hemoptysis, dyspnea, and chest pain.2- General and local chest examination3- Radiographic examination (chest x-ray).4- Tuberculin skin test5- Zeihl-Neelsen staining of smears obtained from sputum andpleural aspirate.1096- Pleural aspiration guided by clinical and radiographic findings.The pleural fluid was subjected to:a) Physical, chemical, cytological and histopathologicalexamination.b) Culture on L-J for acid-fast bacillic) Estimation ofADA enzyme activity.d) PCR for DNA amplification.
|
|
|