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KMID : 1148020190440020111
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조선대학교의대논문집
2019 Volume.44 No. 2 p.111 ~ p.114
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Tuberculous empyema diagnosed by pleural biopsy
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Yang Heon-Yeong
Kim Yong-Wook
Kim Kyoung-Sim
Kim Eun-Young
Kim Young
Jang Hae-In
Cho Hyoung-Min
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Abstract
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Tuberculosis (TB) is still a significant public health problem in Korea. In many cases, it is not easy to diagnose TB. A 13-year-old male patient was admitted for left chest pain for 6 months period. Chest radiography done two months ago during the school screening revealed a pleural effusion in the left lung. All cultures were negative, and 3 sputum samples and his pleural fluid sample tested negative for Acid-fast bacilli. There was no evidence of a malignant effusion. A pleural fluid examination revealed features suggestive of an empyema. Thick and yellowish pus was drawn out. Pleural fluid analysis presented White blood cell 5,200/mm3, and neutrophil-dominant with 60% of neutrophil. In an effort to attain a diagnosis, a video-assisted thoracoscopy procedure was performed with pleural drainage and biopsies. Active chronic granulomatous pleuritis was found through pleural biopsies. He was responsive to treatment and received 6 months of anti-TB therapy with complete clinical resolution. If the clinical picture is in confusion, pleural biopsy is occasionally indicated to diagnose TB pleuritis.
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KEYWORD
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Tuberculosis, Empyema, Pleural biopsy, Pediatrics
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