Contribution of the Xpert MTB/RIF to the etiological diagnosis of tuberculous pleurisy

• Published in: Revue des maladies respiratoires Vol. 34; no. 7; p. 758
• Main Authors: Touré, N O, Wayzani, M, Thiam, K, Cissé, M F, Mbaye, F B
• Format: Journal Article
• Language: French
• Published: France 01-09-2017
• Subjects: Adolescent; Adult; Aged; Biopsy; Cross-Sectional Studies; Drainage; Female; Humans; Male; Mass Screening - methods; Microbiological Techniques - methods; Middle Aged; Mycobacterium tuberculosis - isolation & purification; Pleura - microbiology; Pleura - pathology; Tuberculosis, Pleural - diagnosis; Tuberculosis, Pleural - microbiology; Tuberculosis, Pleural - pathology; Tuberculosis, Pleural - therapy; Young Adult; Biopsie pleurale; Xpert MTB/RIF; Tuberculosis; Pleural tuberculosis; Pleurésie tuberculeuse; Tuberculose; Pleural biopsy
• ISSN: 1776-2588
• DOI: 10.1016/j.rmr.2017.01.003

Performance of the Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in pleural liquid is poorly described. The aim of this study was to determine its usefulness for the etiological diagnosis of a tuberculous pleurisy.
We performed a descriptive cross-sectional study, with analytical design, including all the patients having a unilateral serofibrinous pleurisy, exudative, lymphocytic, and sterile. The diagnosis of pleural tuberculosis was considered based on epidemiological, clinical, paraclinical and therapeutic arguments. The Xpert MTB/RIF of the pleural fluid was carried out among all patients.
Pleural tuberculosis was confirmed in 301 patients. The median age was 32years. Our study has included 217 men (72.1%) with a final sex ratio of 2.6. The cost of the pleural biopsy coupled with histology made it practicable in only 90 patients (29.9%) with a yield of 80%. The Xpert MTB/RIF of the pleural liquid was positive in only 10 patients (3.3% of the cases).
Gene amplification by Xpert MTB/RIF of the pleural liquid is much less effective in establishing the diagnosis of tuberculous pleurisy than pleural biopsy, which remains the gold standard.