Clinic-radiological and etiological profile of pleural effusion patients diagnosed at Tertiary Care hospital of Rajasthan
Singh AK, Jain VK, Mishra M, Maan L
Objective: clinic-radiological and etiological diagnosis of pleural effusion by collecting relevant clinical as well as laboratory data using the recent modalities available in tertiary care hospital. Materials and Methods: This is a prospective study which was conducted in patients who presented with pleural effusion in department of Respiratory medicine of Mahatama Gandhi medical college Hospital, Jaipur which is a tertiary care center. All the patients who are clinic radiologically suspected were broadly evaluated clinically by the Presenting complaints, detailed history, general followed by systemic examination and routine investigations like Complete Blood Count (CBC), pleural fluid cyto-pathological, biochemistry, mirobiological and CBNAAT (Cartridge Based Nucleic Acid Amplification Test) examination were done. Results:Majority of patients were in the age group of 31-40 years (n=70) 35% followed by 20-30 years (n=47) 23.5%. The most common symptom was breathlessness (51.5%), followed by fever (39%), chest pain (38.5%), cough (35%) and weight loss (30%). 116 (58%) cases were of exudative effusion and 84 (42%) cases of transudative effusion. CCF (42/84) 50% is commonest cause of transudative pleural effusion followed by CKD (23/84) 27.3% and cirrhosis (15/84)17.8%. Tuberculosis 46.5% was the common cause of exduative pleural effusion followed by malignancy (27.5%), empyema (11.2%) and Synpneumonic (6.03%). High level of ADA (above 40) were seen in 72.2% (39/54). CBNAAT detected MTB in 21.5% cases among exudative effusion, while cytobiochemistry and pleural biopsy favour tuberculosis 37.1% and 1.7% respectively in exduative effusion. Conclusion: While evaluating a case of pleural effusion, a combined approach, involving clinical evaluation, radiographic and sonographic evaluation, pleural fluid analysis, pleural fluid cytology, and in cases where possible thoracoscopic pleural biopsy, must be utilized to fruitful and accurate diagnosis. CBNAAT could also be useful rapid diagnostic tool for suspected tuberculous pleural effusion/empyema.
Singh AK, Jain VK, Mishra M, Maan L. Clinic-radiological and etiological profile of pleural effusion patients diagnosed at Tertiary Care hospital of Rajasthan. International Journal of Medical and Health Research, Volume 5, Issue 3, 2019, Pages 208-212