2023 Volume 45 Issue 3 Pages 210-214
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.
