Full text
| |
| Author(s): |
Danielle Malta Lima
Total Authors: 1
|
| Document type: | Master's Dissertation |
| Press: | Ribeirão Preto. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC) |
| Defense date: | 2001-10-30 |
| Examining board members: |
Benedito Antonio Lopes da Fonseca;
José Fernando de Castro Figueiredo;
Antonio Ruffino Netto
|
| Advisor: | Benedito Antonio Lopes da Fonseca |
| Abstract | |
The present study evaluates the use of the polimerase chain reaction (PCR) to confirm the etiology of pleural effusions in patients with suspicion of pleural tuberculosis, comparing it to the current available techniques. The diagnosis of pleural tuberculosis is made through the combination of clinical data, radiologic findings, biochemical, microbiological and cytological examination of the pleural fluid and by the pathology of pleural fragment obtained by biopsy. However, these methods present a lot of limitations, including a low sensitivity and a long incubation period to confirm the diagnosis by culture. We studied 58 samples of 45 patients with pleural effusion. Of these, 16 patients had clinical diagnosis or confirmed by laboratory, in a total of 22 samples. We defined as case of tuberculosis all patients with culture or positive pathology in the fluid pleural or other biological material and those with clinical improvement after empirical treatment. Of the 22 samples with the tuberculosis diagnosis PCR was positive in 6 samples of 6 patients. The reaction was positive in a sample of a patient whose diagnosis of tuberculosis was later discarded. The sensitivity, specificity, positive predictive value and negative predictive value in the 16 patients with tuberculosis diagnosis were 31,3%, 96,6%, 83% and 71% respectively. In spite of having presented a low sensitivity, PCR specificity was greater than the conventional methods. This technique can be useful as an additional method to the available techniques, in the attempt of obtaining a more precocious and precise diagnosis in the cases of pleural tuberculosis. (AU) | |