Tuberc Respir Dis > Volume 37(3); 1990 > Article
Tuberculosis and Respiratory Diseases 1990;37(3):300-305.
DOI:    Published online September 1, 1990.
A Clinical Study of Exudative Pleural Effusion in the Elderly
Hee Jin Kim, Kyu Back Lee, Kwang Ho In, Kyung Ho Kang, Se Hwa Yoo
Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
노인의 삼출성 흉막염에 대한 임상적 연구
김희진, 이규백, 인광호, 강경호, 유세화
A clinical analysis of exudative pleural effusion was done on 33 patients who were older than 65 years. All patients were admitted to the Department of Internal Medicin, Korea Univeristy Medical Center to define the causes and characteristics of pluerisy in this age group. Pleural effusion was the major problem on initial presentation for admissions in all cases. The etiologic diagnoses of pleural effusion at the time of discharge were tuberculosis in 14 cases (42%), malignancy in 5 cases (15%), bacterial pneumonia in 2 cases (6%) and nonspecific pleuritis in 12 cases (37%). Tuberculous pleurisy was finally diagnosed in 18 cases. Dyspnea was the most common pressenting symptoms (73%) and chest pain (48%), fever (45%), cough (45%) were other common presenting symptoms. Pleural biopsy performed in 31 cases revealed granulomatous inflammation 14 cases, metastatic malignant lesions in 5 cases and nonspecific pleuritis in 12 cases. Pleural fluid analyses revealed high protein content (3.0 g/ dl) in all. Tuberculous bacilli were cultured in one of 18 cases, bacterial in two and malignant cells were found in 3 of 5 cases. In 18 cases who were followed for more than 6 months, all of 7 cases of tuberculosis and 2 cases of pneumonia showed favorable responses, all of 3 cases of malignancy showed no responses. Six cases of nonspecific pleuritis showed favorable responses in 4 cases and no response in 2 cases with autituberculous chemotherapy. In conclusion, the most common cause of exudative pleurisy in the elderly is tuberculosis and for conclusive diagnosis cytolic examination, pleural biopsy and follow up studies are required.

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