Ms. Van, 60, was diagnosed with pleural tuberculosis after presenting with a prolonged cough, shortness of breath, and a 10 kg weight loss over one year. She also has a 20-year history of hypertension and type 2 diabetes. Further examinations revealed pleural, abdominal, and pericardial effusions.

According to Master, Doctor Tran Duy Hung from the Respiratory Department at Tam Anh General Hospital Hanoi, approximately 200 ml of pink fluid was aspirated from her pericardial and pleural cavities. Analysis of the drained pleural fluid showed a high lymphocyte count, nearly 96%, which raised suspicion of tuberculosis infection or other conditions. Subsequent tests, including bacterial culture, tuberculosis PCR, pleural fluid ADA, cytology tests, bronchoscopy, and pleural biopsy via thoracoscopy, confirmed pleural tuberculosis as the underlying cause of the effusions.

Doctor Hung explained that when tuberculosis bacteria or antigens reach the pleura, the body triggers an inflammatory response, causing fluid and protein to leak out, which leads to pleural effusion. Tuberculosis bacteria can also spread via the bloodstream, lymphatic system, or directly to the pericardium and peritoneum, causing effusions in multiple body cavities.

Doctor Hung aspirates lung fluid from the patient. Photo: Tam Anh General Hospital

Ms. Van received treatment with an anti-tuberculosis drug regimen, along with pleural fluid aspiration to alleviate shortness of breath, management of her underlying conditions, and nutritional support. Following initial treatment, her symptoms improved, her condition stabilized, and the fluid volume showed a decreasing trend. Currently, the patient continues treatment and monitoring under her doctor's regimen.

Patients with pleural tuberculosis often experience persistent symptoms such as coughing, shortness of breath, and chest pain, accompanied by fatigue and weight loss. Diagnosis requires a combination of methods, including fluid analysis, CT scans, and biopsy.

Doctors recommend that individuals with persistent symptoms such as weeks of coughing, progressively worsening shortness of breath, chest pain, or unexplained weight loss seek early medical attention.

Thuy Hanh

*Patient's name has been changed