Causes of pleural exudates in a region with a high incidence of tuberculosis.
OBJECTIVE
To define the causes of exudative pleural effusions in our region.


METHODS
A retrospective study was performed on consecutive patients with exudative pleural effusion seen in our hospital during a 4-year period.


RESULTS
Of 186 patients with a mean age (+/- SD) of 51.2 (+/- 19.2) years with exudative pleural effusions, 131 (70.4%) were males and 55 (29.6%) were females. The most frequent cause of exudative pleural effusions was tuberculosis (44.1%), followed by malignancy (29.6%). The majority (94.5%) of malignant pleural effusions were due to lung cancer. Apart from a patient with bilateral pleural effusions due to cryptococcosis, patients with tuberculous pleural effusion (mean age (+/- SD), 39.7 (+/- 17.5)) were significantly younger than the rest (P < 0.05). Tuberculous effusions were most frequent in the first five decades (60/82, 73.2%) and were the most common type of pleural effusion, accounting for 60 (69.8%) of 86 cases, in this age range. Malignant effusions were more frequent among the older age groups, 74.5% (41/55) of patients with malignant effusions being older than 50 years. Most types of pleural effusions showed a preference for the right side. Of the 44 cases of large effusions, 28 (63.6%) were caused by malignancy.


CONCLUSIONS
In our region with a high incidence of tuberculosis, the most frequent cause of pleural exudates is tuberculosis followed by malignancy, particularly lung cancer.
Liam
C K
CK
Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. ckliam@unimed.po.my
Lim
K H
KH
Wong
C M
CM
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000150:complications; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology*; D016066:Pleural Effusion, Malignant / Q000209:etiology; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology*