Lung flukes Paragonimus heterotremus is a parasitic disease in which transmit by food, occur in 8 Northern mountainous provinces . The incidence of disease is from 0.3 to 15% on human, from 3.3 to 75% on dogs, from 8.7 to 98.1% on mountain scrab and from 1.4 to 3.6 % on snail. Clinical diagnosis based on mainly symptom such as haemoptysis or fluid pleurisy. Diagnosis definetely that have eggs of lung fluke in sputum, in fluid or in feces. Specific treatment medicine is praziquantel. Prevention of its disease by education communication for people and detective patients ealry then use specific treatment medicine
Lung ; Parasitic Diseases ; Pleurisy

PURPOSE: To describe radiologic differences between tuberculous pleural effusion and empyema on the basis of computed tomography(CT). MATERIALS AND METHODS: We reviewed retrosepectively CT findings of 50 patients with pathologically and grossly proved empyema. Twenty-two patients had empyema, and 28 patients had tuberculous pleurisy. RESULTS: CT findings known to be useful in differentiating tuberculous pleural effusion from empyema (1) contour and extent of pleural thickening, (2) mediastinal pleural involvement, (3)accumulation of extrapleural tissue and (4) change of ipsilateral thoraic volume of empyema. However, none of the above findings were helpful in the differential diagnosis of empyema. CONCLUSION: The differentation of tubrculous pleurisy from pyogenic empyema may be not possible with CT findings only.
Diagnosis, Differential ; Empyema* ; Humans ; Pleural Effusion* ; Pleurisy ; Tuberculosis, Pleural

BACKGROUND: Diagnosis of subpulmonary effusion is thought to be somewhat difficut more than pulmonary effusion. Clinical course and pathophysiology are thought to be different from typical pulmonary effusion. This study was done for increasing high suspicious index and early diagnosis of subpulmonary effusion. METHOD: Among the patients at dept. of chest medicine, National Medical Center from January 1990 to Dec. 1993, 232 cases of typical pulmonary effusion and 42 cases of subpulmonary effusion were studied. RESULT: 1) The ratio of subpulmonary effusion and typical pulmonary effusion was about 1:5 2) Male to Female ratio was 1:1 in both effusion. 3) Rt. side pleural and subpleural effusion were slightly predominant. 4) Subjective symptoms are chest pain, cough and exertional dyspnea. There is no difference between subpulmonary and typical pulmonary effusion. 5) Duration of symptom was slightly longer in subpulmonary effusion. 6) The most common cases of pleural effusion is tuberculosis in both subpulmonary & typical pulmonary effusion. Non-specific pleuritis was more common in subpulmonary effusion. 7) Pleural effusion was recurred about one fifth in both subpulmonary & pulmonary effusion. CONCLUSION: We studied clinical course and laboratory findings between subpulmonary & pulmonary effusion. However there are no definite difference between subpulmonary & pulmonary effusion. Duration of symptom was slightly longer in subpulmonary effusion. Most common cause was tuberculosis. Non specific pleuritis was more prevalent in subpulmonary effusion.
Chest Pain ; Cough ; Diagnosis ; Dyspnea ; Early Diagnosis ; Female ; Humans ; Male ; Pleural Effusion ; Pleurisy ; Thorax ; Tuberculosis

BACKGROUND: The clinical manifestation of M. tuberculosis infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-gamma release assay according to the wide spectrum of clinical phenotypes. METHODS: In patients diagnosed with active TB that underwent QuantiFERON(R) (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. RESULTS: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). CONCLUSION: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.
Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Pleurisy ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

A pseudochylothorax, a chyliform pleural effusion, is a rare disease of pleural effusion that contains cholesterol crystals or high lipid content that is not the result of a disrupted thoracic duct. Most of the cases were found in patients with long-standing pleural effusion due to chronic inflammatory disease, such as old tuberculous pleurisy or chronic rheumatoid pleurisy. We experienced a case of pseudochylothorax in a 74-year-old man, who was being treated for pulmonary tuberculosis and pleurisy 10 years ago. The diagnosis was confirmed on pathological study of the pleural effusion, which contained cholesterol crystals having a diagnostic rhomboid appearance.
Aged ; Cholesterol ; Humans ; Pleural Effusion ; Pleurisy ; Rare Diseases ; Thoracic Duct ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: It is quite difficult to differentiate intestinal tuberculosis from Crohn's disease because of the similarities of their clinical and pathological features and low detection rate of acid fast bacilli. The diagnostic value of PCR has been studied in pulmonary tuberculosis, tuberculous pleuritis and meningitis, but few reports were made in cases of intestinal tuberculosis. The aim of this study is to evaluate the diagnostic value of PCR in intestinal tuberculosis. METHODS: The subjects, a total of 70 cases are composed of clinically diagnosed intestinal tuberculosis, Crohn's disease and intestinal Behcet's disease. We performed PCR with paraffin-embedded intestinal tissue to detect the DNA of Mycobacterium Tuberculosis and the data was analyzed. RESULTS: The positive rate of PCR for Mycobacterium Tuberculosis was 9.8% (4/41) in intestinal tuberculosis, 0% (0/29) in Crohn's disease, and 0% (0/3) in intestinal Behcet's disease. The granulomas were not found in 50% (2/4) of the PCR positive intestinal tuberculosis cases. CONCLUSIONS: We were not able to find evidences to prove the excellent value of PCR assay in making differential diagnosis of intestinal tuberculosis from other granulomatous diseases. But it might be helpful in detecting cases of intestinal tuberculosis which were not pathologically or microbiologically confirmed.
Crohn Disease ; Diagnosis, Differential ; DNA ; Granuloma ; Meningitis ; Mycobacterium tuberculosis ; Pleurisy ; Polymerase Chain Reaction* ; Tuberculosis* ; Tuberculosis, Pulmonary

BACKGROUND: pH measurement is an important test in assessing the etiology of pleurisy and in identifying complicated parapneumonic effusion. Although the blood gas analyzer is the' gold standard method' for pleural pH measurement, pH meter & pH strip methods are also used for this purpose interchangably. However, the correlation among the pH data measured by the three different methods needs to be evaluated. In this study, we measured the pH of pleural fluid with the three different methods respectively and evaluated the correlation among the measured data. METHODS: From August 1999 to March 2000, were measured the pleural fluid pH in 34 clinical samples with three methods-blood gas analyzer, pH meter, and pH strip. In the blood gas analyzer and pH meter methods, the temperature of plerual fluid was maintained around 0℃ in air-tight condition before analysis and measurement was performed within 30 minutes after collection. As for the pH strip method, the pleural fluid pH was checked in the ward immediately after tapping and in the clinical laboratory of our hospital. This part is unclear. RESULTS: The causes of pleural effusion were tuberculosis pleurisy in 16 cases, malignant pleural effusion 5 cases, parapneumonic effusion 9 cases, empyema 3 cases, and congestive heart failure 1 case. The pH of pleural fluid (mean±SD) was 7.34±0.12 with blood gas analyser, 7.52±0.25 with pH meter, 7.37±0.16 with pH strip of immediate measurement and 6.93±0.201 with pH strip of delayed measurement. The pH measured by delayed pH strip measurement was lower than those of other methods(p<0.05). The correlation of the results between the blood gas analyzer and pH meter(p=0.002, r=0.518) and the blood gas analyzer and pH strip of immediate measurement(p<0.001, r=0.607). CONCLUSION: In the determination of pH of pleural fluid, pH strip method could be a simple and reliable method under immediate measurement conditions after fluid tapping.
Empyema ; Heart Failure ; Hydrogen-Ion Concentration* ; Methods* ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy ; Tuberculosis

Tuberculous (TB) pleuritis is the second most common form of extrapulmonary tuberculosis. Because the yield of pleural fluid mycobacterial culture is as low as 20% and the pleural biopsy is rather invasive, the measurement of adenosine deaminase (ADA) has been a cornerstone of the diagnosis of TB pleuritis. If the ADA level of pleural fluid is higher than 70 IU/L, the diagnosis of TB pleuritis can be made safely. The treatment is based on a standard short course anti-TB treatment starting with isoniazid, rifampicin, ethambutol, and pyrazinamide. Although systemic steroids and drainage of pleural fluid have been tried to reduce the residual pleural thickening, the results are contradicting.
Adenosine Deaminase ; Biopsy ; Drainage ; Ethambutol ; Isoniazid ; Pleural Effusion ; Pleurisy ; Pyrazinamide ; Rifampin ; Steroids ; Tuberculosis

BACKGROUND: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. METHODS: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age,sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. RESULTS: 1) Group 1 patients had lower glucose level{63.3+/-30.8(mg/dl)} than that of the group 2{98.5+/-34.2(mg/dl), p<0.05}, and higher LDH level{776.3+/-266.0(IU/L)} than the group 2 patients{376.3 +/-123.1(IU/L), p<0.05), and also longer duration of symptom before treatment{2.0+/-1.7(month)} than the group 2{ 1.1 +/-1.2(month), p<0.05)}, respectively. 2) In group 1, FVC changed from preoperative 2.55+/-0.80(L) to postoperative 2.99+/-0.78(L)(p<0.05), and FEV1 changed from preoperative 2.19 +/- 0.70(L/sec) to postoperative 2.50+/-0.69(L/sec) (p<0.05). 3) There was no difference in pleural fluid protein level(5.05+/-1.01(gm/dL) and 5.15+/-0.77 (gm/dl), p>0.05) and WBC differential count between group 1 and group 2. CONCLUSION: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.
Biochemistry ; Cell Count ; Drug Therapy ; Dyspnea ; Glucose ; Humans ; Pleural Effusion* ; Pleurisy ; Prospective Studies ; Tuberculosis, Pleural*

Splenic abscesses in the tropics assume importance because of their unusual aetiology. They may be secondary or primary. Splenic tuberculosis is rare and a delay in diagnosis is common. The authors report a patient with splenic and mesenteric tuberculosis who was admitted to the hospital because of an abdominal cyst incidentally detected on ultrasonogram during prenatal fetal monitoring in the Department of Obsterics. The patient had already been treated with anti-tuberulous drugs for the previous 18 months after being diagnosed as tuberulous pleuritis. Abdominal sonography and computerized tomography revealed the presence of multiple hypoechoic and hypodense splenic lesions and mesenteric cysts. Diagnostic splenectomy and excision of the mesenteric cysts revealed multiple necrotic masses in the spleen, consistent with the microscopic findings of caseating granulomatous inflammation. Following splenectomy, the patient was also treated with an anti-tuberculosis regimen with no recurrence of symptoms.
Abscess* ; Diagnosis ; Fetal Monitoring ; Humans ; Inflammation ; Mesenteric Cyst ; Pleurisy ; Recurrence ; Spleen ; Splenectomy ; Tuberculosis ; Tuberculosis, Splenic ; Ultrasonography