TUBERCULOUS PLEURAL EFFUSION IN THE EASTERN PROVINCE OF SAUDI-ARABIA

The incidence and clinical pattern of tuberculous pleural effusion (TP E) and the contribution of individual laboratory procedures in the dia gnosis of TPE were assessed in a five year prospective study. Two hund red and fifty-three patients presenting in three participating hospita ls with pleural effusion (PE) were assessed clinically and had various laboratory investigations. Eighty-nine (35.2%) of them, including 73 (82%) men and 31 (34.8%) Saudis had TPE. Their mean age +/- SD was 33. 4 +/- 11.2 years. Main symptoms in rank order were cough (80%), fever (75%), shortness of breath (64%), chest pain (61%), anorexia and weigh t loss (47%). PPD was positive in 82 (92%) patients. Positive culture or histological evidence of tuberculosis (TB) was observed in pleural biopsy (68.5%), pleural fluid (10%) and sputum (2%). Pleural fluid mic roscopy was positive in only one patient, chest radiological features of TB in 3 (3.4%). Six months anti-TB therapy resulted in complete rec overy in 86 patients. It is concluded that in this community TPE const itutes over a third of all the causes of PE. The relatively young age of patients reflects the age structure of the indigenous population as well as immigrant workers. PPD, histology and culture of pleural biop sy were the most useful tools while pleural fluid and sputum microscop y were unhelpful. The 6-months anti-TB therapy was excellent.