title: Amplified Mycobacterium tuberculosis direct test for diagnosing tuberculous pleurisy--a diagnostic accuracy study.
abstract: BACKGROUND
  The study was designed to investigate the clinical usefulness of Amplified Mycobacterium Tuberculosis Direct (AMTD) tests for diagnosing TB pleurisy.
  
  
  METHODS
  One hundred and fifty-two patients for whom the exclusion of tuberculous pleural effusion was necessary were retrospectively analyzed.
  
  
  RESULTS
  The sensitivity of AMTD in diagnosing pleural TB was 36.4% (20 of 55). Combining sputum and pleural effusion AFB smear, pleural biopsy, and AMTD test of pleural effusion increased sensitivity to 82.5% (33/40). There were significantly higher percentages of neutrophils in the pleural effusion in the positive than in the negative AMTD group (38.0 ± 6.7% vs. 11.1 ± 3.7%, p<0.001). Patients with symptom duration <18 days prior to pleural effusion studies had more positive AMTD tests than those with symptom >18 days (70% vs. 31.4%; OR 5.09; 95% CI 1.54-16.79; p = 0.011).
  
  
  CONCLUSIONS
  Combining AMTD tests with conventional diagnostic methods offer good sensitivity for pleural TB diagnosis. Patients in the early course of the disease are better candidates for AMTD tests.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan.
authors.forename: Chieh-Mo
authors.initials: CM
authors.lastname: Lin
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Lin
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Chung
authors.forename: Horng-Chyuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Kang-Yun
authors.initials: KY
authors.lastname: Lee
authors.forename: Chien-Da
authors.initials: CD
authors.lastname: Huang
authors.forename: Chih-Hsi
authors.initials: CH
authors.lastname: Kuo
authors.forename: Chien-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Wang
authors.forename: Han-Pin
authors.initials: HP
authors.lastname: Kuo
mesh_terms: D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010996:Pleural Effusion / Q000209:etiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014396:Tuberculosis, Pleural / Q000150:complications / Q000175:diagnosis*