TY - JOUR T1 - Performance of Xpert MTB/RIF on pleural tissue for the diagnosis of pleural tuberculosis JF - European Respiratory Journal JO - Eur Respir J SP - 1427 LP - 1429 DO - 10.1183/09031936.00103213 VL - 42 IS - 5 AU - Devasahayam J. Christopher AU - Samuel G. Schumacher AU - Joy S. Michael AU - Robert Luo AU - Thangakunam Balamugesh AU - Paramasivan Duraikannan AU - Nira R. Pollock AU - Madhukar Pai AU - Claudia M. Denkinger Y1 - 2013/11/01 UR - http://erj.ersjournals.com/content/42/5/1427.abstract N2 - To the Editor:Tuberculosis (TB) remains the second leading cause of death from an infectious disease in adults. Extrapulmonary TB (EPTB) accounts for about 25% of all cases of active TB. Pleural TB is the second most common manifestation of EPTB.Existing tests for the diagnosis of pleural TB have major limitations in terms of accuracy, time to diagnosis and drug resistance testing, and require special expertise for sample acquisition and interpretation of the results. Biopsy of the pleural tissue for combined histological examination and culture is considered the diagnostic gold standard, albeit imperfect [1, 2].The Xpert MTB/RIF assay (Xpert; Cepheid, Sunnyvale, CA, USA) is a rapid, World Health Organization (WHO) endorsed, automated PCR test optimised for respiratory specimens that can detect both Mycobacterium tuberculosis (MTB) and rifampicin resistance [3, 4]. Given the limitations of available tests for the diagnosis of pleural TB, several studies have evaluated the performance of Xpert using pleural fluid as a sample type. Overall, these studies show limited accuracy with sensitivity averaging around 44% [5–7]. However, the preferred specimen for the diagnosis of pleural TB is pleural tissue. To date, the evaluation of Xpert performed on pleural tissue has been limited to isolated samples within larger studies [4, 6, 7].We enrolled consecutive adult patients that were evaluated for pleural TB in the pulmonary clinic and inpatient ward at the Christian Medical College, Vellore, India. Pleural TB was suspected based on clinical symptoms and radiographic evidence of a pleural effusion. Information on demographics, comorbidities, presenting symptoms and results of diagnostic evaluation were collected prospectively. The institutional review boards of the Christian Medical College … ER -