title: Tuberculous pleurisy as a manifestation of primary and reactivation disease in a region with a high prevalence of tuberculosis.
abstract: METHODS
  A teaching hospital in Malaysia.
  
  
  OBJECTIVE
  To review the demographic and clinical features of patients with pleural tuberculosis (TB).
  
  
  METHODS
  Retrospective chart and chest radiograph review.
  
  
  RESULTS
  The chest radiograph of 54 (61.4%) of a total of 88 patients with pleural TB did not show any lung infiltrate (considered a manifestation of primary TB), while that of 32 (36.3%) patients showed infiltrates in the upper lobes or superior segment of the lower lobes, or the presence of parenchymal scarring in the upper lobes (typical of reactivation TB). Additionally, the chest radiograph of two (2.3%) patients showed miliary mottling (also classified as having primary TB). The mean age of patients with primary versus reactivation tuberculous pleurisy was 36.3 (+/-14.8) years and 44.6 (+/-19.3) years, respectively (P = 0.041). The median duration of symptoms before presentation was 14 days and 60 days in patients with primary and reactivation disease, respectively (P = 0.001).
  
  
  CONCLUSIONS
  In Malaysia, where the prevalence of TB is high, tuberculous pleurisy is more commonly a manifestation of primary rather than reactivation disease. Patients with primary TB pleurisy are younger and have a shorter duration of symptoms than those with reactivation TB pleurisy.
authors.affiliation: Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. ckliam@unimed.po.my
authors.forename: C K
authors.initials: CK
authors.lastname: Liam
authors.forename: K H
authors.initials: KH
authors.lastname: Lim
authors.forename: C M
authors.initials: CM
authors.lastname: Wong
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*