Derrame pleural tuberculoso: características clínicas de 320 pacientes

espanolObjetivos Analizar las caracteristicas clinicorradiologicas y del liquido pleural (LP) de los pacientes con derrame pleural tuberculoso (DPT). Metodos Analisis retrospectivo de los DPT atendidos en nuestro centro durante los ultimos 23 anos. Resultados Se estudiaron 320 pacientes con DPT (70% varones; mediana de edad 33 anos). En el 36% de los casos se identifico Mycobacterium tuberculosis en esputo o LP mediante examen microscopico, cultivos en medios solidos y liquidos, o amplificacion de acidos nucleicos. El mayor porcentaje de identificaciones microbiologicas se relaciono con una co-infeccion por el virus de la inmunodeficiencia humana (VIH) (OR: 3,27) y con la presencia en LP de unas proteinas 60% (OR: 3,23) o glucosa Conclusiones Los pacientes con DPT co-infectados por VIH o que presentan concentraciones bajas de proteinas en LP tienen mayor frecuencia de aislamientos microbiologicos y fallecimientos. Asimismo, los pacientes de mayor edad muestran mas opacidades pulmonares y mortalidad. EnglishObjectives To analyze the clinical and radiological characteristics and features of pleural fluid (PF) in patients with tuberculous pleural effusion (TPE). Methods Retrospective analysis of TPEs treated in our clinic over the last 23 years. Results We included 320 patients with TPE (70% men; median age 33 years). Mycobacterium tuberculosis was identified in the sputum or PF of 36% of the patients by microscopic examination, solid and liquid media cultures, or nucleic acid amplification tests. The greatest percentage of positive microbiological findings were associated with human immunodeficiency virus (HIV) co-infection (OR: 3.27), and with the presence in PF of proteins 60% (OR: 3.23), and glucose Conclusions Patients with TPE and HIV co-infection and those with lower concentrations of proteins in PF had higher rates of positive microbiological results and death. Moreover, older patients had more pulmonary opacities and a higher incidence of death.