Abstract
Introduction: Tuberculous pleurisy is one of the most common form of extrapulmonary tuberculosis (TB). Measurement of adenosine deaminase (ADA) level in the effusions is advocated to have a high diagnostic yield in the diagnosis of tuberculous pleurisy as well as pericardial and peritoneal effusions due to TB. The diagnostic yield of ADA measurement in other materials such as abscess content has never been published before. Case report: In this report we present a case of tuberculous pleurisy in whom ADA level in the pleural fluid was not higher than expected while it was very high in the drained material of cold abscess due to TB. Conclusion: To the best of our knowledge this is the first case study reporting the measurement of ADA in the content of a cold abscess due to TB. In conclusion, we suggest that ADA measurement in all kinds of liquid or caseous material other than effusions may have a diagnostic role in TB.
Highlights
Tuberculous pleurisy is one of the most common form of extrapulmonary tuberculosis (TB)
A relatively noninvasive method, pleural fluid adenosine deaminase (ADA) measurement has been advocated in the diagnosis of tuberculous pleurisy with high sensitivity and specificity [1, 2]
ADA levels higher than 47 IU/L, in lymphocytic pleural effusions are highly suggestive of tuberculous pleurisy [3]
Summary
Tuberculous pleurisy is one of the most common form of extrapulmonary tuberculosis (TB). Measurement of adenosine deaminase (ADA) level in the effusions is advocated to have a high diagnostic yield in the diagnosis of tuberculous pleurisy as well as pericardial and peritoneal effusions due to TB. Case report: In this report we present a case of tuberculous pleurisy in whom ADA level in the pleural fluid was not higher than expected while it was very high in the drained material of cold abscess due to TB. A relatively noninvasive method, pleural fluid adenosine deaminase (ADA) measurement has been advocated in the diagnosis of tuberculous pleurisy with high sensitivity and specificity [1, 2]. ADA levels higher than 47 IU/L, in lymphocytic pleural effusions are highly suggestive of tuberculous pleurisy [3]. It should be kept in mind that there are other diseases could cause high ADA levels in the pleural effusions such as rheumatoid pleurisy, empyema, lymphoma and malignant mesothelioma [4]
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