Tuberculous Pleural Effusion: Sensitivity and Specificity

Introduction: Tuberculosis can cause exudative pleural effusions and is notoriously difficult to diagnose. The effusion is reactive and often does not contain mycobacteria. See also Exudative Pleural Effusion and Tuberculosis.

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The sensitivity and specificity of findings for Tuberculous Pleural Effusion are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive Findings
Finding	Result	Sensitivity	Specificity
[ + ] Elevated total protein		Sensitivity = 98.8%
Study: Arch Intern Med, 158 (18), 2017-21 (1998) PMID: 9778201
[ + ] Adenosine Deaminase	+ 0 -	93.8%	82.5%
cut-off of 45 IU/L Study: BMC Infect Dis. 2013; 13: 546. PMID: 24238276
[ + ] Lymphocytic Predominance		Sensitivity = 93.3%
more than 50% of leukocytes were lymphocytes Study: Arch Intern Med, 158 (18), 2017-21 (1998) PMID: 9778201

Poorly Diagnostic Findings
Finding	Result	Sensitivity	Specificity
[ + ] Pleural Biopsy		Sensitivity = 79.8%
caseating granulomas on biopsy (not organisms) Study: Arch Intern Med, 158 (18), 2017-21 (1998) PMID: 9778201
[ + ] Purified Protein Derivative (PPD)		Sensitivity = 66.5%
Study: Arch Intern Med, 158 (18), 2017-21 (1998) PMID: 9778201