What causes pleural effusion TB?

What causes pleural effusion TB?

Development of tuberculous pleural effusion may occur as a result of delayed hypersensitivity reaction to mycobacteria or mycobacterial antigens in the pleural space in sensitized individuals [10] or by rupture of a subpleural focus of pulmonary disease into the pleural space [11].

What are mesothelial cells in pleural fluid?

The pleural mesothelial cell (PMC) is the most common cell in the pleural space and is the primary cell that initiates responses to noxious stimuli (3). PMCs are metabolically active cells that maintain a dynamic state of homeostasis in the pleural space.

What causes reactive mesothelial cells?

There are many causes of reactive mesothelial cells including: infection, inflammation, infarction, liver disease, radiation, chemotherapy, systemic disease, trauma, foreign materials, and neoplasia (DeMay 2012).

Can TB cause bilateral pleural effusion?

During the treatment course of pulmonary TB, some patients may develop pleural effusion. One study found 29 patients who developed pleural effusions while receiving chemotherapy for pulmonary (16 patients) or extra-pulmonary TB (13 patients) [81].

Can pleural effusion TB be cured?

Although it is curable, tuberculosis remains one of the most frequent causes of pleural effusions on a global scale, especially in developing countries. Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis.

How do you know if pleural effusion is malignant?

Malignancy is the most common cause of massive pleural effusion and, if this is the case, clinical signs may be obvious. Chest signs consistent with the pleural effusion include reduced expansion, dull percussion note, reduced breath sounds, and reduced vocal resonance.

Are there mesothelial cells in tuberculous pleural effusions?

Sprigg et al 3 first called attention to the paucity of mesothelial cells in tuberculous pleural effusions. In no instance of 65 specimens of tuberculous effusions were mesothelial cells found in a proportion greater than 2.5 per 1,000 WBC.

How are pleural mesothelial cells derived from the mesoderm?

Pleural mesothelial cells (PMCs) derived from the mesoderm play a key role during the development of the lung. The pleural mesothelium differentiates to give rise to the endothelium and smooth muscle cells via epithelial-to-mesenchymal transition (EMT).

What causes turbidity of the pleural fluid in adults?

Observing the gross appearance of the pleural fluid may suggest a particular cause. For example, turbidity of the pleural fluid can be caused either by cells and debris (i.e., empyema) or by a high lipid level (i.e., chylothorax).

How is pleural effusion treated in pulmonary tuberculosis?

Treatment regimens are identical to those administered for pulmonary TB. Initial pleural drainage may have a role in symptom relief and in hastening the resolution of the effusion. Surgical intervention may be required in loculated effusions and empyemas. Keywords: empyema; pleural biopsy; pleural effusion; thoracentesis; tuberculosis.