Clinicopathologic characteristics of pediatric tuberculous pleural effusion: a retrospective analysis of 112 consecutive cases.

The aim of this study was to describe the clinicopathologic characteristics of pediatric tuberculous pleural effusion (TPE) patients to make an accurate diagnosis.Pediatric TPE patients who admitted to Shandong Provincial Chest Hospital were retrospectively reviewed from March 2006 to April 2015.112 pediatric TPE patients were enrolled. The mean age was 11.6 ± 3.2 years. 60 (53.6%) patients were diagnosed as TPE, 40 (35.7%) were TPE+Pulmonary tuberculosis (PTB). 96 (85.7%) patients had fever (> 37°C), 81 (72.3%) had dyspnea, 63 (56.3%) had cough. Radiological test results showed effusions on the right side in 58 patients (51.8%), on the left side in 50 patients (44.6%), and on both sides in 4 patients (3.6%). 6 (5.4%) patients were acid-fast bacilli (AFB) smear-positive. 16 (14.3%) PCR positive patients were identified. 41 (36.6%) TB patients were culture-positive. Almost all effusions (99.1%) had the biologic characteristics of exudates. In 91.2% of the effusions, more than 50% of leukocytes were lymphocytes. Pleural adenosine deaminase (40 U/L) was positive in 74.5% of the patients, and erythrocyte sedimentation rate was raised in 84.1%.The usefulness of routine microbiological tests to diagnose pleural TB is limited by its poor sensitivity. Further studies should be performed to validate new techs and assays for pediatric TPE.