Features of detection and diagnosis of tuberculous pleurisy in patients with cirrhosis of the liver
https://doi.org/10.54921/2413-0346-2022-10-2-28-33
Abstract
Rationale. It is known that patients with cirrhosis of the liver are more susceptible to tuberculosis due to impaired immunity. In this regard, the diagnosis of tuberculous exudative pleurisy in patients with cirrhosis of the liver is an urgent medical problem.
Purpose. To evaluate the features of detection, differential diagnosis and course of tuberculous exudative pleurisy in patients with liver cirrhosis.
Materials and methods. Based on archived case histories, an analysis was made of clinical, radiological, laboratory and microbiological examination data of 84 patients aged 17 to 82 years with pleural effusion and cirrhosis of the liver.
Results. Hydrothorax in patients with liver cirrhosis had a tuberculous etiology in 21.4% of cases, and in 61.1% of cases tuberculous pleurisy was combined with pulmonary tuberculosis, in 50.0% it was accompanied by the release of mycobacterium tuberculosis with sputum, lethal outcome was observed in 11.1% of patients. For the purpose of early detection of tuberculous pleurisy in patients with liver cirrhosis and hydrothorax, regular fluorographic examinations of patients are necessary, and if tuberculosis is suspected, the use of microbiological and morphological methods for verifying the diagnosis is necessary.
About the Author
N. A. Stogova
ФГБОУ ВО «Воронежский государственный медицинский университет им. Н.Н. Бурденко» Минздрава России, кафедра фтизиатрии
Russian Federation
Russian Federation
References
1. Agrawal P., Shrestha T.M., Prasad P.N., Aacharya R.P., Gupta P. Pleural fluid serum bilirubin ratio for differentiating exudative and transudative effusions // J. Nepal Med. Assoc. – 2018. –Vol. 56. – N. 211. – P. 662-665.
2. Cartin-Ceba R., Krowka M.J. Pulmonary complications of portal hypertension // Clin. Liver Dis. – 2019. – Vol. 23. – N. 4. – P. 683-711. doi: 10.1016/j.cld.2019.06.003.
3. Chaaban T., Kanj N., Bou Akl. I. hepatic hydrothorax: an updated review on a challenging disease // Lung. – 2019. – Vol. 197. – N. 4. – P. 399-405. doi: 10.1007/s00408-019-00231-6.
4. Chinchkar N.J., Talwar D., Jain S.K. A stepwise approach to the etiologic diagnosis of pleural effusion in respiratory intensive care unit and short-term evaluation of treatment // Lung India. – 2015. – Vol. 32. – N. 2. – P. 107-115. doi: 10.4103/0970-2113.152615.
5. Dahale A.S., Puri A.S., Sachdeva S., Agarwal A.K., Kumar A., Dalal A., Saxena P.D. Reappraisal of the role of ascitic fluid adenosine deaminase for the diagnosis of peritoneal tuberculosis in cirrhosis // Korean J. Gastroenterol. – 2021. – Vol. 78. – N. 3. – P. 168-176. doi: 10.4166/kjg.2021.068.
6. Gananandan K., Cropley I., Westbrook R. Tuberculosis in a patient with cirrhosis. // Clin. Gastroenterol. Hepatol. – 2019. – Vol. 17. – N. 12. – P. A32. doi: 10.1016/j.cgh.2018.07.034.
7. Gilbert C.R., Shojaee S., Maldonado F., Yarmus L.B., Bedawi E., Feller-Kopman D., Rahman N.M., Akulian J.A., Gorden J.A. Pleural interventions in the management of hepatic hydrothorax // Chest. – 2022. – Vol. 161. – N. 1. – P. 276-283. doi: 10.1016/j.chest.2021.08.043.
8. Lee C.Y., Tsai H.C., Lee S.S., Sy C., Chen Y.S. Disseminated tuberculosis presenting as tuberculous peritonitis and sepsis tuberculosa gravissima in a patient with cirrhosis of the liver: A diagnosis of challenge // J. Microbiol. Immunol. Infect. – 2016. – Vol. 49. – N. 4. – P. 608-612. doi: 10.1016/j.jmii.2013.12.008.
9. Light R.W., Lee Y.C.G. Editors. Textbook of Pleural Diseases. 3rd ed. – Hardback, 2016. – 675 p.
10. Lv Y., Han G., Fan D. Hepatic hydrothorax // Ann. Hepatol. – 2018. – Vol. 17. – N. 1. – P. 33-46. doi: 10.5604/01.3001.0010.7533.
11. Matei D., Craciun R., Crisan D., Procopet B., Mocan T., Pasca S., Zaharie R., Popovici B., Sparchez Z. Hepatic hydrothorax-an independent decompensating event associated with long-term mortality in patients with cirrhosis // J. Clin. Med. – 2021. – Vol. 10. – N. 16. – P. 3688. doi: 10.3390/jcm10163688.
12. Sharma D., Kc S., Jaisi B.J. Prevalence of tuberculosis in patients with liver cirrhosis // Nepal Health Res. Counc. – 2018. – Vol. 15. – N. 3. – P. 264-267. doi: 10.3126/jnhrc.v15i3.18852.
13. Sharma P., Tyagi P., Singla V., Bansal N., Kumar A., Arora A. Clinical and biochemical profile of tuberculosis in patients with liver cirrhosis // J. Clin. Exp. Hepatol. – 2015. – Vol. 5. – N. 1. – P. 8-13. doi: 10.1016/j.jceh.2015.01.003.
14. Sieloff E.M., Ladzinski A.T., Alcantara Lima N., Vos D., Boamah H., Melgar T.A. Hospitalizations for tuberculous peritonitis in the United States: Results from the national inpatient sample database from 2002 to 2014 // Int. J. Mycobacteriol. – 2020. – Vol. 9. – N. 2. – P. 167-172. doi: 10.4103/ijmy.ijmy_68_20.
15. Soin S., Sher N., Saleem N. Spontaneous bacterial empyema: an elusive diagnosis in a patient with cirrhosis // BMJ Case Rep. – 2018. – 2018:bcr2018224810. doi: 10.1136/bcr-2018-224810.
Review
For citations:
Stogova N.A. Features of detection and diagnosis of tuberculous pleurisy in patients with cirrhosis of the liver. Tuberculosis and socially significant diseases. 2022;10(2):28-33. (In Russ.) https://doi.org/10.54921/2413-0346-2022-10-2-28-33
Views:
69
Email this article 