Tuberculosis is differential diagnosis in developing world

doi:10.1136/bmj.39115.403287.1F

BMJ 2007;334:273-274 (10 February), doi:10.1136/bmj.39115.403287.1F

Letters

Malignant pleural effusion

Tuberculosis is differential diagnosis in developing world

The first 100% of the full text of this article appears below.

In countries with a high prevalence of tuberculosis,malignancy is still the commonest cause of bloody pleural effusion,but the next most common causes are tuberculosis and trauma.¹ ² Accordingly, in the absence of associatedstigmata of malignancy, even pleural effusion whose outwardappearance is highly suggestive of malignancy should be consideredto be potentially tuberculous, and appropriate tests shouldbe instigated if initial investigations do not confirm malignancy.In this context, appropriate tests for tuberculosis includenot only closed biopsy (with histology and culture),¹ but alsomeasurement of interferon ${gamma}$ in the pleural fluid.³

Oscar M Jolobe, retired geriatrician

¹ Didsbury, Manchester M20 2RN oscarjolobe@yahoo.co.uk

Competing interests: None declared.

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