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General Practice 2023

Pleural tuberculosis: what é, symptoms and treatment

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Pleural tuberculosis: what é, symptoms and treatment
Pleural tuberculosis: what é, symptoms and treatment

Pleural tuberculosis is an infection of the pleura, which is the thin film that lines the lungs, by Koch's bacillus, causing symptoms such as chest pain, cough, shortness of breath and fever.

This is one of the most common types of extra-pulmonary tuberculosis, that is, it manifests outside the lungs, such as the bone, throat, lymph nodes or kidneys, being a more common situation in people with weakened immunity, such as people with AIDS, cancer or using corticosteroids, for example. Learn more about what it is and how to identify extrapulmonary tuberculosis.

To treat pleural tuberculosis, the pulmonologist, or the infectious disease specialist, usually indicates a treatment regimen of at least 6 months, with 4 antibiotic drugs, which are Rifampicin, Isoniazid, Pyrazinamide and Ethambutol.

Main symptoms

The symptoms of pleural tuberculosis are:

  • Dry cough;
  • Chest pain, arising during breathing;
  • Fever;
  • Increased night sweats;
  • Difficulty breathing;
  • Slimming without apparent cause;
  • Disease;
  • Loss of appetite.

Usually, the first symptom presented is cough, which is accompanied by a slight pain in the chest. After a few hours, the other symptoms begin to set in and get worse, until the person has difficulty breathing and a feeling of shortness of breath.

Whenever there is a suspicion of a lung problem, it is very important to go to the hospital or consult a pulmonologist to start treatment as soon as possible and avoid possible complications.

How contagion happens

Pleural tuberculosis is not contagious, as Koch's bacillus is not present in lung secretions, and is not easily transmitted through sneezing or coughing. Thus, whoever acquires this type of tuberculosis needs to be contaminated by people with pulmonary tuberculosis, who, when coughing, spread large amounts of bacteria in the environment.

Next, the microorganisms reach the pleura after spreading through the bloodstream or directly from lesions formed in the lung. Some people can also develop pleural tuberculosis as a complication of, for example, pulmonary tuberculosis.

How to confirm the diagnosis

To diagnose pleural tuberculosis, in addition to evaluating the person's symptoms and history, the doctor may also order tests, such as:

  • Analysis of pleural fluid to detect enzymes present in the infection, such as lysozyme and ADA;
  • Chest X-ray;
  • Sputum test for tuberculosis bacillus (BAAR);
  • Mantoux test, also known as tuberculin skin test or PPD. Understand how it is done and when it is indicated;
  • Broncoscopy.

The chest X-ray may show lesions in the pleura, such as thickening or calcification, or a pleural effusion, also known as water in the lung, which usually affects only 1 of the lungs. Understand better what it is and the other possible causes of pleural effusion.

How the treatment is done

Pleural tuberculosis may have a spontaneous cure in some cases, even without treatment, however, treatment is usually done with a combination of 4 antibiotics called Rifampicin, Isoniazid, Pyrazinamide and Ethambutol.

Fever may disappear within two weeks, but may persist for six or eight weeks, and pleural effusion resolves within six weeks, but may persist for three to four months.

In general, the patient shows significant improvement in the first 15 days of treatment, but it is important to take the medication prescribed by the doctor even in the absence of symptoms, as the bacillus takes a long time to be completely removed from the body. Find out more details about the ways to treat tuberculosis.

Is pleural tuberculosis curable?

Pleural tuberculosis has a 100% chance of cure. However, if the treatment is not performed properly, there may be complications such as the development of tuberculosis in other regions of the body.

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