Tuberculous pleuritis

Last revised by Yuranga Weerakkody on 27 Nov 2021

Tuberculous pleuritis is a form of pleural tuberculosis and refers to inflammation of the pleura due to infection by Mycobacterium tuberculosis. It is considered the second most common form of extra-pulmonary tuberculosis 1. It may progress into a tuberculous empyema.

It may be commoner in young males and afflicted patients tend to be younger than those who get pulmonary tuberculosis 2.

In most cases, tuberculous pleuritis is believed to stem from either rupture of a subpleural granuloma into the pleural space or dissemination of the mycobacteria via pleural lymphatics.

Imaging findings may vary depending on stage/chronicity of disease. There is often pleural thickening and in certain stages, a pleural effusion may be present 7. Co-existing parenchymal lesions of tuberculosis may be observed in a high proportion of patients (e.g. over 80% 3,6). Classically, some cases may demonstrate a pleural tuberculoma. Ultrasound of the chest will demonstrate septations with a loculated pleural effusion 8

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