Setting: A 2500-bed hospital.
Objectives: To clarify characteristics of tuberculous pleuritis (TP) with pleural effusion culture positive and negative for Mycobacterium tuberculosis (PECP-MT and PECN-MT) and to identify risk factors for fatality.
Patients and methods: Retrospective analysis of TP patients with PECP-MT and PECN-MT, and review of medical charts of deceased patients.
Results: Of 126 patients enrolled (28 PECP-MT and 98 PECN-MT), those with PECP-MT had a higher prevalence of steroid use (SU) (14.3% vs. 2.0%; P = 0.022) and concurrent tuberculosis involving another site (7.2% vs. 0.0%; P = 0.048), increased neutrophils (36.4% vs. 16.6%; P = 0.020) and decreased glucose levels (mean 88.7 vs. 127.6 g/dl; P = 0.012) in pleural effusion, and a higher fatality rate (28.0% vs. 3.1%; P < 0.001). Deceased patients (n = 10) were older (mean 74.2 vs. 64.4 years; P = 0.047), had a higher incidence of acute renal failure (ARF) (50.0% vs. 11.7%; P = 0.007), and a higher prevalence of malignancy (40.0% vs. 6.3%; P = 0.006), history of stroke (30.0% vs. 7.2%; P = 0.048) and SU (20.0% vs. 1.8%; P = 0.034).
Conclusion: SU, concurrent tuberculosis involving another site, increased neutrophils and decreased glucose levels in pleural effusion may be predictive factors for PECP-MT. Malignancy, ARF and SU, and perhaps being elderly or history of stroke, are risk factors for fatality in patients with TP.