A Case of Bilateral Tuberculous Pleurisy Preceded by Peritonitis and Diagnosed by Thoracoscopy Under Local Anesthesia

DOI
  • Goto Nozomi
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Kohnoh Takashi
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Ito Ryota
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Kodama Yuta
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Inagaki Masayasu
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Nakase Atsushi
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Tsushima Yusuke
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Shirahige Aya
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Matsuura Akihiko
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
  • Yokoyama Toshihiko
    Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital

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Other Title
  • 腹膜炎が先行し局所麻酔下胸腔鏡検査にて診断に至った両側結核性胸腹膜炎の1例

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Abstract

<p>Background. Tuberculous pleurisy and peritonitis are often challenging to diagnose because of limited specific laboratory findings. Case. A 78-year-old woman admitted for abdominal pain who had been initially diagnosed with peritonitis of unknown cause was referred to our department due to bilateral pleural effusion. The pleural fluid showed an exudative effusive nature with mononuclear cell predominance and high adenosine deaminase levels. Thoracoscopy under local anesthesia was performed due to suspicion of tuberculous pleurisy, a diagnosis that was confirmed based on tuberculosis polymerase chain reaction and pathological findings of the biopsied pleural tissue. The patient received treatment with three anti-tuberculosis drugs (isoniazid, rifampicin, and ethambutol), after which the peritonitis and bilateral pleural effusion improved. Conclusion. Thoracoscopy under local anesthesia was useful for the diagnosis of an unusual case of tuberculous pleurisy that presented with bilateral pleural effusion following peritonitis.</p>

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