Diagnosis of tuberculous pleural effusions: A review

Respir Med. 2021 Nov;188:106607. doi: 10.1016/j.rmed.2021.106607. Epub 2021 Sep 6.


Tuberculous pleural effusion (TPE) is the second most common presentation of extrapulmonary tuberculosis. The paucibacillary nature of the effusion poses diagnostic challenges. Biomarkers like adenosine deaminase and interferon-γ have some utility for diagnosing TPEs, as do cartridge-based polymerase chain reaction (PCR) methods. When these fluid studies remain indeterminate, pleural biopsies must be performed to confirm the diagnosis. This review article elaborates on the scientific evidence available for various diagnostic tests and presents a practical approach to the diagnosis of TPEs.

Keywords: Pleural biopsies; Pleural effusion; Pleuroscopy; Thoracoscopy; Tuberculosis; Tuberculous pleural effusion.

Publication types

  • Review

MeSH terms

  • Biomarkers / analysis
  • Biopsy
  • Diagnosis, Differential
  • Humans
  • Pleural Effusion / diagnosis*
  • Pleural Effusion / microbiology*
  • Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Tuberculosis, Pleural / diagnosis*


  • Biomarkers