SIMILAR PLEURAL FLUID FINDINGS IN PLEUROPULMONARY TULAREMIA AND TUBERCULOUS PLEURISY

Biochemical and cellular characteristics of pleural fluid from two pat ients with pleuropulmonary tularemia and 39 patients with tuberculous pleurisy were compared. High pleural fluid concentrations of adenosine deaminase, lysozyme, and beta(2)-microglobulin occurred in both disea ses. As is the case with tuberculous pleural effusions, pleural fluid in tularemia showed an abundance of lymphocytes, predominantly CD4-pos itive T lymphocytes. The similar pleural fluid findings suggest analog ous local pathogenetic mechanisms in tularemia and tuberculosis. In th e diagnostic evaluation of a lymphocyte-rich exudative pleural effusio n with a high adenosine deaminase concentration, a possible cause to c onsider is tularemia.