Abstract

This comparative and prospective study was designed in order to investigate the diagnostic value of bedside inoculation of pleural fluids (PF), which were obtained from the adult patients with tuberculous pleurisy, into the BACTEC liquid medium. Thoracentesis and pleural biopsy were performed for all the patients with exudative pleurisy. PF were subdivided into three groups: Group 1 was inoculated into the liquid medium at the bedside. Group 2 and 3 were inoculated into the Lowenstein-Jensen (L-J) medium after being transported to the laboratory in the tubes with and without anticoagulant, respectively. Additionally, cytological analysis was done for all PF. Histopathological analysis and cultivation in the L-J medium were performed for all biopsy materials. Of the 66 cases, a total of 43 were diagnosed as tuberculosis. M. tuberculosis was isolated in 16 (37.2%) of the PF inoculated at the bedside. Mycobacterial growth in the pleural biopsies cultivated in the L-J medium was observed in 4 (9.3%) of the cases and 3 of these also had positive cultures in the PF inoculated into the liquid medium at the bedside. None of the PF transported in the tubes with or without anticoagulant and cultivated in the L-J medium showed mycobacterial growth. Resistance against H was found in one of the cases with positive mycobacterial culture, whereas another case was resistant to both H and S. In conclusion, bedside inoculation of PF into the BACTEC liquid medium enhanced the isolation rate of M. tuberculosis as compared with the cultivation methods performed in the L-J medium.