“ROLE OF TB PCR IN CLINICALLY DIAGNOSED AND TREATED CASES OF TUBERCULAR PLEURAL EFFUSION”.

Abstract

Background: Tuberculosis is still a major health problem worldwide. It is estimated that about one-third of the world's population is infected with mycobacterium tuberculosis. While pulmonary tuberculosis is most common presentation; pleural effusion is one of the common complications of primary tuberculosis or in conjunction with pulmonary infiltrate typical of post primary tuberculosis. Diagnosis of pleural tuberculosis (TB) remains a challenge due to its nonspecific clinical presentation and paucibacillary nature.TB PCR is a self-automated method from Roche for the detection of mycobacterium tuberculosis. This test allows for detection and identification of MTB from direct specimens within 24 – 48 hours of the receipt in the laboratory. We determined the role of TB PCR in diagnosis of tubercular etiology in pleural effusion in our study. Materials and methods: Prospective and analytical studyin a tertiary care centre of the study area was conducted after Ethics Committee permission. The study period was from June 2018 to December 2019.Data of 36tubercular pleural effusion patients was retrieved. Role of TB PCR in the diagnosis of tubercular etiology was assessed. Results: Pleural fluid samples collectedwere sent for various investigations like Routine microscopy, cytology, Pleural fluid pH, protein, LDH and TB PCR. Serum protein and serum LDH were also done.The diagnosis of Tubercular Pleural Effusion was made by clinical examination, radiological presentation, results of pleural fluid investigations and response to Anti Tubercular treatment collectively. Out of the 36 patients diagnosed to have tubercular pleural effusion, 8(22%) patient’s pleural fluid TB PCR report was positive. Conclusion:TB PCR is not a useful test in the diagnosis of tubercular etiology in pleural effusion.