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Tuberculous pleuritis — SCE Respiratory MCQ

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ModeratePleural DiseaseTuberculous pleuritisSCE Respiratory

A 37-year-old man from India has fever, night sweats and a unilateral lymphocytic exudative pleural effusion. Pleural fluid culture is pending, cytology is negative and adenosine deaminase is markedly elevated. What is the most likely diagnosis?

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Correct answer: E — Tuberculous pleuritis

A lymphocytic exudative effusion with systemic symptoms and high ADA in a high-risk patient is most suggestive of tuberculous pleuritis. Heart failure is usually transudative. PE can cause an exudate but does not typically produce very high ADA with night sweats and epidemiological risk.

Reference: BTS Pleural Disease Guideline 2023; NICE NG33 TB