Tuberculous Pleural Effusion: Likelihood Ratios

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 likelihood ratios of findings for Tuberculous Pleural Effusion are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Adenosine Deaminase

5.4

0.1

cut-off of 45 IU/L

Study: BMC Infect Dis. 2013; 13: 546. PMID: 24238276

Poorly Diagnostic Findings

Finding	+LR	-LR	Comments, Study
Elevated total protein	Sensitivity = 98.8%		Study: Arch Intern Med, 158 (18), 2017-21 (1998) PMID: 9778201
Lymphocytic Predominance	Sensitivity = 93.3%		more than 50% of leukocytes were lymphocytes Study: Arch Intern Med, 158 (18), 2017-21 (1998) PMID: 9778201
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