Clinical Profile of Tubercular Empyema with Special Reference to Diagnostic Role of Cartridge Based Nucleic Acid Amplification test (CBNAAT)
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 10
Abstract
Introduction: Tuberculosis is continuing to be a significant burden in the developing world and tubercular empyema thoracis still remains a common entity with significant morbidity and mortality. Clinical course of tubercular empyema is often accompanied by bronchopleural fistula, concomitant pulmonary tuberculosis and unfavourable outcome. Aim: A prospective study was conducted to assess the clinical presentation of tubercular empyema with special emphasis on evaluating diagnostic role of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and outcome issues. Materials and Methods: A prospective study was carried out consisting of adult cases of tubercular empyema admitted in the department of Respiratory Medicine in a teaching hospital in eastern India over a period of 18 months. Tubercular empyema cases were analysed on the basis of clinicoradiological features, diagnostic challenges with special interest on role of newer molecular diagnostic test like CBNAAT, management and outcome issues. Results: A total of 40 cases of tubercular empyema were encountered during the study period. Tubercular empyema frequently affected young population (mean age 31.5 years) with a male preponderance (72.5%). Thirty five (87.5%) patients had a duration of illness of more than one month on presentation. There was frequent accompaniment of concomitant pulmonary tuberculosis (60%) and bronchopleural fistula (42.5%). Sputum smear for acid fast bacilli (55%) and CBNAAT (57.5%) were positive in good number of cases. Pleural fluid smear for acid fast bacilli and CBNAAT yield were also very high (72.5% and 92.5% respectively). Pleural fluid CBNAAT had a sensitivity of 92.5% (95% CI: 79.61-98.43) and specificity of 100% (95% CI: 93.51-100) in diagnosis of tubercular empyema. Mean duration of Intercostal tube drainage was 45.6 days and eighteen patients needed decortication. Conclusion: Tubercular empyema is a disease affecting the young population most commonly, has a chronicity in clinical course and is commonly complicated by presence of associated pulmonary tuberculosis, bronchopleural fistula and unfavourable outcome. Pleural fluid and sputum CBNAAT have good yield in diagnosis.
Authors and Affiliations
SUBHASIS MUKHERJEE, SHABANA BEGUM, SOMENATH KUNDU, SUBHRA MITRA
Keywords
Related Articles
- EP ID EP364767
- DOI 10.7860/JCDR/2017/31193.10689
- Views 62
- Downloads 0
Study of Red Cell Fragility in Different Stages of Chronic Kidney Disease in Relation to Parathyroid Hormone
Introduction: Anaemia is one of the common complications associated with Chronic Kidney Disease (CKD) responsible for the increase in the morbidity and mortality in such patients. Several factors have been attributed to...
MR Imaging Features of Non Convulsive Status Epilepticus: A Great Masquerader
ABSTRACT Variable clinical presentation and overlapping imaging findings make Non Convulsive Status Epilepticus (NCSE) a diagnostic challenge. NCSE is known to be a heterogeneous disorder with varied causes and several s...
Effect of Botulinum Toxin Type A on Functional Mobility in Cerebral Palsy with Lower Limb Spasticity
ABSTRACT Introduction: Children with Cerebral Palsy (CP) often start walking much later than typically developing children and they do so with a slower speed and higher energy cost. Mobility varies across different envir...
Effects of Aerobic Exercise on Frontal EEG Asymmetry, Coherence and Mood: A Pilot Study
ABSTRACT Introduction: Electroencephalographically-measured frontal alpha asymmetry is shown to reflect changes in mood. Negative mood changes are purported to limit exercise capacity in some groups, thereby contributing...
Mobile Phone and its Effect on Foetal Cardiotocography Pattern
ABSTRACT Introduction: Mobile phones have become a part and parcel of our every day’s life. As they operate by creating an electromagnetic field therefore, there are concerns for their safety while using in pregnancy. Ai...