Tuberculous Polyserous Effusions: A Case Report And Review Of The Literature

ObjectiveTo have a better understanding of the clinical and laboratory examination characteristics of tuberculous polyserous effusions, and improve the ability to make a correct diagnosis.Patients and methodsOne patient with tuberculous polyserous effusions was described and relevant literatures were reviewed.ResultTuberculous polyserous effusions is common, predilection in the middle-aged and young men. It take a long time diagnosis, with an average of about 4 months. The clinical manifestations vary widely, depending on the sensitivity of Mycobacterium tuberculosis in patients and the amount of effusion. Patients, who have a high sensitivity and considerable effusions, usually have a acute onset and striking tuberculous toxic symptoms, such as fever, night-sweat, chest pain, otherwise having no obvious manifestations. It's particularly important for differential diagnosis, as a result of multiple causes of serous effusions. Other causes for serous effusions mainly including malignant tumors (especially lung cancer), connective tissue disease, cirrhosis, cardiac insufficiency, renal insufficiency and hypoproteinemia. Tuberculous polyserous effusions has a high rate of clinical misdiagnosis and delayed diagnosis, Imaging examinations such as ultrasound and CT are useful to a certain excent, laboratory examinations, especially effusion examinations, are necessary to make a final diagnosis. TB inspection and culture, the PPD test, TB antibody, ADA value, TB-CPR and CEA value etc. contribute to early diagnosis. However, the sensitivity and specificity of these laboratory tests is not high, When there is no positive test results, the more difficult to differential diagnosis. Endoscopy biopsy can help us to diagnose the intractable cases. A fast, easy, cheap and accurate method is needed for early diagnosis. Regular anti-TB and pumping fluid therapy, with a small amount of hormone, can relief the uncomforts rapidly, so that the disappearance of serous effusions with no sequelae, and provide a good prognosis. Some cases of delayed diagnosis for long can have varying degrees of serosal thickening, surgery is considered if organ functions were severely affected.ConclusionTuberculous polyserous effusions has a high rate of clinical misdiagnosis and delayed diagnosis, there still lacks a fast, easy, cheap and accurate method is needed for early diagnosis. Clinical manifestations and imaging features have a extent valve, but a positive TB dyeing and other relevant examinations are necessary to make the final diagnosis, Endoscopy biopsy is important, too. If necessary, particularly when the positive results in laboratory diagnosis of TB can not be get, which can brought more difficulties in the differential diagnosis, tentative anti-tuberculosis treatment or diagnostic thoracotomy, laparotomy can be used.