RELAPSE RATE OF TUBERCULOUS PLEURAL EFFUSION AMONG PATIENTS WITH RESIDUAL PLEURAL THICKENING AFTER COMPLETING SHORT COURSE DIRECTLY OBSERVED TREATMENT: RELAPSE RATE OF TUBERCULOUS PLEURAL EFFUSION

Residual pleural thickening (RPT) is a common residual aftertuberculous pleural effusion (TPE) treatment but it is unclear what the tuberculosis(TB) relapse rate is among Thai patients with RPT. In this study we aimed todetermine the TB relapsed rate among patients with RPT who had been treatedby short course directly observed treatment (DOTS) and determine theprevalence, clinical characteristics, radiographic findings and pleural fluidanalysis results of patients with RPT in order to inform TB control programs. Weretrospectively reviewed the medical records of patients with TPE who presentedto Srinagarind Hospital, Khon Kaen University, Thailand between 1 January2014 and 30 November 2019, looking for evidence of relapse in these patients forat least 18 months after completing therapy for TPE. A total of 49 subjects wereincluded in the study; 31 (63%) were male. Thirty-seven subjects (76%) developedRPT. The mean (+standard deviation (SD)) age of subjects with RPT was 53 (+17)years and subjects without RPT was 52 (+19). The common presenting symptomsamong study subjects were: cough in 32 subjects (65%), fever in 25 subjects (51%),dyspnea in 21 subjects (43%) and pleuritic chest pain in 12 subjects (25%). Thecommon underlying illnesses among subjects were: hypertension in 14 subjects(29%), diabetes mellitus in 8 subjects (16%) and chronic kidney disease in 6subjects (12%). Thirty-four subjects (69%) were treated with the standard regimenof isoniazid, rifampicin, ethambutol and pyrazinamide for 2 months followed byisoniazid and rifampicin for 4 months (2IRZE/4IR). None of the TPE cases weretreated with therapeutic thoracentesis or pleurodesis. There were no relapses ofTB among patients with RPT. Our results suggest the current management of TPEcases using DOTS is adequate to prevent relapse of TB.