Are acid-fast bacillus stains of pleural fluid useful in the diagnosis of tuberculous pleural effusions?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Because most tuberculous pleural effusions probably result from a hypersensitivity reaction to the Mycobacterium rather than from microbial invasion of the pleura, acid-fast bacillus stains of pleural fluid are rarely diagnostic (< 10% of cases). Pleural fluid cultures grow M tuberculosis in less than 65% of cases.

In contrast, the combination of histology and culture of pleural tissue obtained by pleural biopsy increases the diagnostic yield for TB to 90%.


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