Pleural Effusion in Pulmonary Tuberculosis Patients: A Case Review and Diagnostic Challenges with Radiological Examination
Keywords:
Computed Tomography, Tuberculous Pleural Effusion, Radiology, UltrasonographyAbstract
Tuberculous pleural effusion is a common form of extrapulmonary tuberculosis, especially in regions with a high tuberculosis incidence. This condition may result from an immunological response to Mycobacterium tuberculosis infection or the rupture of subpleural lesions into the pleural cavity. This study aims to assess the role of radiological examination in diagnosing tuberculous pleural effusion and compare the accuracy of different imaging modalities, including chest radiography, computed tomography (CT) scans, and ultrasonography. The study adopts an analytical observational design involving a 74-year-old male patient suspected of having pulmonary tuberculosis with right-sided pleural effusion. The diagnosis was supported by clinical evaluation, radiological assessment, and laboratory analysis of pleural fluid. Chest radiography in the posteroanterior (PA) position revealed active pulmonary tuberculosis with right pleural effusion. Radiological examinations, particularly CT scans and ultrasonography, play a crucial role in distinguishing tuberculous pleural effusion from other causes, such as malignancy or parapneumonic effusion. Early detection through accurate imaging facilitates better clinical decision-making, ensuring optimal patient treatment.
References
Samanta, J. Et Al. Pulmonary Tuberculosis Among Patients Of Tubercular Pleural Effusion: A Single-Center Experience. Int J Mycobacteriol 12, 139-143 (2023).
Shaw, J. A. & Koegelenberg, C. F. N. Pleural Tuberculosis. Clinics In Chest Medicine Vol. 42 Preprint At Https://Doi.Org/10.1016/J.Ccm.2021.08.002 (2021).
Lo Cascio, C. M., Kaul, V., Dhooria, S., Agrawal, A. & Chaddha, U. Diagnosis Of Tuberculous Pleural Effusions: A Review. Respiratory Medicine Vol. 188 Preprint At Https://Doi.Org/10.1016/J.Rmed.2021.106607 (2021).
Arunsurat, I., Reechaipichitkul, W., So-Ngern, A., Ratanawatkul, P. & Chumpangern, W. RELAPSE RATE OF TUBERCULOUS PLEURAL EFFUSION AMONG PATIENTS WITH RESIDUAL PLEURAL THICKENING AFTER COMPLETING SHORT COURSE DIRECTLY OBSERVED TREATMENT. Vol. 52 (2021).
Amit Chopra, Mdj. T. H. M. Tuberculous Pleural Effusion. Wolters Kluwerjournal (2025).
Selvy Wulandari, Fajrinur Syahrani, Ade Rahmaini & Putri Chairani Eyanoer. Pleural Fluid Leukocyte Level Test For Establishing Tuberculous Pleural Effusion In Patients With Exudative Pleural Effusion. J Respir Indo Vol. 34 (2021).
Rahman, M. Z. Et Al. On Examination And Radiological Findings Of Tubercular And Malignant Pleural Fluid Collected From Patients Presented With Exudative Pleural Effusion. Journal Of Current And Advance Medical Research 9, 74-78 (2023).
Mcnally, E., Ross, C. & Gleeson, L. E. The Tuberculous Pleural Effusion. Breathe Vol. 19 Preprint At Https://Doi.Org/10.1183/20734735.0143-2023 (2023).
Putri, H. & Rahmah V. PERBEDAAN GAMBARAN EFUSI PADA PEMERIKSAAN THORAX PROYEKSI TEGAK DAN SUPINE DENGAN KLINIS EFUSI PLEURA. Jurnal Malahayati (2023).
Krishna, R., Antoine, M. H., Alahmadi, M. H. & Rudrappa, M. Pleural Effusion Continuing Education Activity. NCBI Bookshelf (2025).
Marvellini, R. Y. & Izaak, R. P. GAMBARAN RADIOGRAFI FOTO THORAX PENDERITA TUBERKULOSIS PADA USIA PRODUKTIF DI RSUD PASAR MINGGU (Periode Juli 2016 Sampai Juli 2017). Jurnal Kedokteran (2021).
Rai, S. P. V., K., L. Y., Alok, K. & Akshita, G. Imaging Of Pleural Tuberculosis: A Narrative Review. Indographics 03, 150-155 (2024).
Sari GK, Sarifuddin & Setyawati T. TUBERKULOSIS PARU POST WODEC PLEURAL EFUSION: LAPORAN KASUS PULMONARY TUBERCULOSIS POST WODEC PLEURAL EFFUSION: CASE REPORT. Jurnal Medical Profession (Medpro) (2022).
Kadukar, J. Et Al. Drug-Resistant (DR) Tubercular Pleural Effusion: A Rare Case. Cureus (2022) Doi:10.7759/Cureus.31185.
Saber, S., Islam Chowdhury, Md. F., Hossain, M. M. & Islam, MD. R. An Observational Study On Clinical Profiles Of Tuberculous Pleural Effusion Patients In A Tertiary Care Teaching Hospital, Dhanmondi, Dhaka, Bangladesh. European Journal Of Medical And Health Sciences 5, 69-73 (2023).
Hendrawardani, D. A. C. Efusi Pleura Pada Tuberkulosis Ekstra Paru Dengan Riwayat Lupus Eritematosus Sistemik Di Puskesmas Sukasada II: Sebuah Laporan Kasus. Intisari Sains Medis 14, 497-503 (2023).
Thiagarajan, D. Et Al. Tuberculous Pleural Effusion In A Patient With Sympathetic Ophthalmia On Immunosuppression: A Case Report. Trop Dis Travel Med Vaccines 7, (2021).
Bachtiar, N. A. Et Al. Pulmonary Tuberculosis CT-Scan Features And Sputum Smear In Tertiary Referral Hospital. Nusantara Medical Science Journal 5, 80-86 (2020).
Dong, Z. Et Al. Paradoxical Development Of Pleural-Based Masses In Patients With Pleural Tuberculosis During Treatment: A Clinical Observational Study In China. BMC Pulm Med 22, (2022).
Lipman, K., Lin, C., Kennelly, M. & Patel, S. The Diagnostic Challenges Of Pleural Tuberculosis: A Case Report. Journal Of Brown Hospital Medicine 3, (2024).
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Nidaul Khairy Nurfan, Shofiyah Latief, Nur Ahmad Tabri (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors publishing here keep copyright but grant the journal first publication rights, under a Creative Commons Attribution-NonCommercial 4.0 License. They can distribute their work non-exclusively elsewhere with an acknowledgment of its first publication in this journal. Posting the work online before and during submission for earlier and greater citation is encouraged, reflecting Open Access benefits.
