Polymerase chain reaction of pleural biopsy specimens for rapid diagnosis of tuberculous pleuritis.

SETTING

Government-administered regional teaching hospital.

OBJECTIVE

To improve timeliness and sensitivity of laboratory diagnosis of tuberculous pleuritis.

DESIGN

We applied polymerase chain reaction (PCR) to detect DNA (IS6110) specific for Mycobacterium tuberculosis complex in pleural biopsy specimens.

RESULTS

Of 28 patients with pleural disease, 11 were diagnosed by microbiology (smear/culture of sputum or pleural fluid) with tuberculous pleuritis, eight were diagnosed with tuberculous pleuritis by histology (of pleural biopsies) and/or clinical presentation, and nine were diagnosed with carcinomatous pleuritis. Seventeen of the patients' pleural biopsies were PCR positive. Based on microbiological results, the sensitivity of the PCR assay was 100% (11/11). On the other hand, based on the results of the histological and clinical data, sensitivity and specificity of the PCR results were 89% (17/19) and 100% (9/9), respectively.

CONCLUSION

PCR of pleural biopsy specimens can be a useful method when employed in combination with microbiological and histological examinations of pleural biopsy for rapid diagnosis of tuberculous pleuritis.