Thoracoscopic pleural biopsy as an aid to diagnosis in pediatric tuberculosis with pleural involvement.

Introduction: Successful treatment of tuberculosis relies on microbiological diagnosis and drug sensitivities. Due to the pauci-bacillary nature of childhood infection, this is often not possible. We describe the successful microbiological diagnosis of tuberculosis using thoracoscopic pleural nodule biopsy.

Material And Methods: In seven patients presenting with pulmonary tuberculosis and pleural involvement, but in whom microbiological diagnosis could not be established, thoracoscopic pleural biopsy was performed and analyzed for histology, acid-fast bacilli, polymerase chain reaction (PCR), DNA, culture, and drug sensitivities.

Results: In five out of the seven patients we achieved positive histology, culture, and drug sensitivities. In the remaining two patients, histology, PCR, and DNA probe were positive for tuberculosis.

Conclusions: Thoracoscopic pleural biopsy is a sensitive aid to the diagnosis of pleural tuberculosis in children.