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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Clinical Profile of Tubercular Empyema with Special Reference to Diagnostic Role of Cartridge Based Nucleic Acid Amplification test (CBNAAT) OC01-OC05
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Clinical Profile of Tubercular Empyema with Special Reference to Diagnostic Role of Cartridge Based Nucleic Acid Amplification test (CBNAAT) OC01-OC05

机译：结核性脓胸的临床资料，特别是基于墨盒的核酸扩增试验（CBNAAT）OC01-OC05的诊断作用

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Introduction: Tuberculosis is continuing to be a significant burden in the developing world and tubercular empyema thoracis still remains a common entity with significant morbidity and mortality. Clinical course of tubercular empyema is often accompanied by bronchopleural fistula, concomitant pulmonary tuberculosis and unfavourable outcome.Aim: A prospective study was conducted to assess the clinical presentation of tubercular empyema with special emphasis on evaluating diagnostic role of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and outcome issues.Materials and Methods: A prospective study was carried out consisting of adult cases of tubercular empyema admitted in the department of Respiratory Medicine in a teaching hospital in eastern India over a period of 18 months. Tubercular empyema cases were analysed on the basis of clinicoradiological features, diagnostic challenges with special interest on role of newer molecular diagnostic test like CBNAAT, management and outcome issues.Results: A total of 40 cases of tubercular empyema were encountered during the study period. Tubercular empyema frequently affected young population (mean age 31.5 years) with a male preponderance (72.5%). Thirty five (87.5%) patients had a duration of illness of more than one month on presentation. There was frequent accompaniment of concomitant pulmonary tuberculosis (60%) and bronchopleural fistula (42.5%). Sputum smear for acid fast bacilli (55%) and CBNAAT (57.5%) were positive in good number of cases. Pleural fluid smear for acid fast bacilli and CBNAAT yield were also very high (72.5% and 92.5% respectively). Pleural fluid CBNAAT had a sensitivity of 92.5% (95% CI: 79.61-98.43) and specificity of 100% (95% CI: 93.51-100) in diagnosis of tubercular empyema. Mean duration of Intercostal tube drainage was 45.6 days and eighteen patients needed decortication.Conclusion: Tubercular empyema is a disease affecting the young population most commonly, has a chronicity in clinical course and is commonly complicated by presence of associated pulmonary tuberculosis, bronchopleural fistula and unfavourable outcome. Pleural fluid and sputum CBNAAT have good yield in diagnosis.
机译：简介：结核病在发展中国家仍然是一个沉重的负担，结核性脓胸仍然是一个常见的实体，具有很高的发病率和死亡率。结核性脓胸的临床病程通常伴有支气管胸膜瘘，伴发性肺结核和不良预后。目的：进行一项前瞻性研究，以评估结核性脓胸的临床表现，特别侧重于评估基于盒式核酸扩增试验（CBNAAT）的诊断作用材料和方法：进行了一项前瞻性研究，包括在印度东部一家教学医院的呼吸内科住院的结核性脓胸成年病例，历时18个月。根据临床放射学特征，诊断挑战对新出现的CBNAAT等分子诊断测试的作用，管理和结局问题进行了分析。结果：在研究期间共遇到40例结核性脓胸。结核性脓胸经常影响年轻人（平均年龄31.5岁），其中男性占多数（72.5％）。三十五（87.5％）例患者病情持续时间超过一个月。伴有肺结核（60％）和支气管胸膜瘘（42.5％）。耐酸杆菌（55％）和CBNAAT（57.5％）的痰涂片检查在很多病例中均为阳性。耐酸性杆菌的胸水涂片和CBNAAT产率也很高（分别为72.5％和92.5％）。胸水CBNAAT诊断结核性脓胸的敏感性为92.5％（95％CI：79.61-98.43），特异性为100％（95％CI：93.51-100）。结论：结核性脓胸是一种最普遍影响年轻人口的疾病，在临床上具有慢性病性，并伴有相关的肺结核，支气管胸膜瘘和不利因素，平均行肋间管引流时间为45.6天，需要去皮。结果。胸水和痰液CBNAAT的诊断率较高。

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