Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

Pleural Mycobacterial Infections

  • Helen C. WainwrightEmail author
Reference work entry


Tuberculous pleural effusion


It refers to an accumulation of serofibrinous fluid within the pleural space, usually occurring shortly after a primary tuberculous infection. Spread may occur directly through the visceral pleura from the pulmonary focus or from adjacent tuberculous hilar or mediastinal lymph nodes. Blood spread is the more likely cause when there are bilateral tuberculous pleural effusions. Alternate routes of spread are from the pericardium or pleural lymphatics. In developed countries, it may be a manifestation of reactivated infection. It is the second most common site of extrapulmonary tuberculosis (EPTB).

Clinical Features

  • Incidence

    The incidence varies according to the degree of industrialization of the country. There are over 500,000 cases of tuberculous pleural effusion diagnosed annually worldwide.

    Pleural TB occurs in 5% of TB cases in the USA; in Spain, 10–23%; in Malaysia, 10–12%; and in Turkey, 30%.

    Coinfection with HIV has resulted in...

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References and Further Reading

  1. Dheda, K., Van-Zyl Smit, R. N., Sechi, L. A., Badri, M., et al. (2009). Clinical diagnostic utility of IP-10 and LAM antigen levels for the diagnosis of tuberculous pleural effusions in a high burden setting. PLoS ONE, 4(3), e4689.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Gopi, A., Madhavan, S. M., Sharma, S. K., & Sahn, S. A. (2007). Diagnosis and treatment of tuberculous pleural effusion in 2006. Chest, 131, 880–889.CrossRefPubMedGoogle Scholar
  3. Kumar, P., Sen, M. K., Chauhan, D. S., Katoch, V. M., et al. (2010). Assessment of the N-PCR assay in diagnosis of pleural tuberculosis : Detection of M.tuberculosis in pleural fluid & sputum collected in tandem. PLoS ONE, 5(4), e10220.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Nicol, M. P., & Wilkinson, R. J. (2008). The clinical consequences of strain diversity in Mycobacterium tuberculosis. Transactions of the Royal Society of Tropical Medicine and Hygiene, 102, 955–965.CrossRefPubMedGoogle Scholar
  5. Porcel, J. M. (2009). Tuberculous pleural effusion. Lung, 187, 263–270.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Anatomical PathologyUCT Faculty of Health ScienceCape TownSouth Africa