PT  - JOURNAL ARTICLE
AU  - Gunatilake, Samal
AU  - Babu, Suresh
AU  - Whitehead, Nuala
AU  - Reichmann, Michaela
AU  - Chauhan, Anoop
TI  - A review of pleural fluid TB culture at a large acute UK hospital
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2601
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2601.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2601.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - BackgroundThe British Thoracic Society (BTS) recommend pleural fluid TB culture (TBC) should only be requested where there is clinical suspicion of TB pleuritis. Many clinicians request TBC when investigating pleural effusions regardless of clinical suspicion.ObjectivesTo examine the sensitivity of pleural fluid TBC in TB patients.To audit the appropriateness of pleural fluid TBC requests.To determine if enhanced clinical information increased the utility of TBC.MethodWe assessed pleural fluid from TB patients and clinical information accompanying all pleural fluid TBC requests at our hospital between Jan 2008 and Dec 2012. Clinical information suspecting TB on the request form was considered a high level of suspicion. Absence of information was considered a low level of suspicion.ResultsThe prevalence of pleural effusion in TB was low 6/120 (5%). The sensitivity of pleural fluid TBC in cases of TB presenting with a pleural effusion was 33%.Of 918 pleural fluid samples, 67 (7.3%) had a high clinical suspicion. The positive predictive value (PPV) of pleural fluid TBC with high clinical suspicion was 3% (table 1). The remaining 851 had low clinical suspicion with a negative predictive value of 100%.View this table:DiscussionThe prevalence of TB diagnosed by pleural fluid TBC is low (2/918). Clinical suspicion of TB did not significantly improve the PPV. No patients with a low clinical suspicion cultured TB. Our data supports BTS recommendations that pleural fluid TBC should only be requested when TB pleuritis is suspected.