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Epidemiología y resultados en un grupo de pacientes con sospecha clínica de tuberculosis pleural en la ciudad de Bogotá (Colombia). Serie de casos
Epidemiology and results in a group of patients with clinical suspicion of pleural tuberculosis in the city of Bogota (Colombia). Case report
DOI:
https://doi.org/10.15446/rsap.v27n2.118141Palabras clave:
Mycobacterium tuberculosis, tuberculosis pleural, cultivo, pruebas moleculares (es)Mycobacterium tuberculosis, pleural tuberculosis, culture, molecular tests (en)
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Objetivo Caracterizar los pacientes y evaluar la utilidad diagnóstica de las pruebas moleculares y fenotípicas en el diagnóstico de tuberculosis pleural (TBP) en la ciudad de Bogotá.
Métodos Se recolectaron 80 muestras de líquido pleural. A cada muestra se le realizó: PCR en tiempo real (qPCR-IS6110); Genotype MTBDRplus®2.0; PCR múltiple IS6110-hsp65; PCR-IS6110; baciloscopia; cultivo en medio líquido (MGIT) y en medios sólidos (Lowenstein Jensen y Stonebrink modificado por Giraldo). Se incluyeron datos paraclínicos como: citoquímico, ADA, VIH y cáncer.
Resultados 17/80 (21,25%) pacientes fueron positivos para TBP, utilizando métodos moleculares; de estos, 10/17 fueron tratados. La TBP fue diagnosticada más en hombres (82,4%), y en pacientes con VIH (58,8%). El cultivo y la baciloscopia fueron positivos en 2/17 pacientes, el ADA fue positivo en 8/17 pacientes.
Conclusiones Se muestra una realidad diagnóstica, relacionada con dificultad en la identificación del bacilo tuberculoso en la TBP; son la clínica del paciente y el criterio médico los que dirigen la toma de decisiones.
Objective To characterize patients and evaluate the diagnostic utility of molecular and phenotypic tests in the diagnosis of pleural tuberculosis (TBP) in the city of Bogotá.
Methods 80 pleural fluid samples were collected. Each sample was subjected to: real-time PCR (qPCR-IS6110); Genotype MTBDRplus®2.0; multiplex PCR IS6110-hsp65; PCR-IS6110; smear microscopy; culture in liquid (MGIT) and solid media (Lowenstein Jensen and Stonebrink modified by Giraldo). Paraclinical data were included: cytochemistry, ADA, HIV, and cancer.
Results 17/80 (21.25%) patients were positive for TBP using molecular methods; of these 10/17 were treated. TBP was diagnosed more in men (82.4%), and in patients with HIV (58.8%). Culture and smear microscopy were positive in 2/17 patients, ADA was positive in 8/17 patients.
Conclusions A diagnostic reality is shown, related to the difficulty in identifying the tubercle bacillus in TBP; it is the patient's clinical condition and medical criteria that guide the decision making process.
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