Objective This study aimed to describe the clinical and laboratory findings of patients diagnosed with pleural tuberculosis (PT) at two tertiary university hospitals in Southern Brazil. Methods Patients below 18 years of age admitted to the study hospitals were retrospectively evaluated. Medical and epidemiological history, tuberculin skin test (TST) results, radiological and pathological findings, and pleural fluid (PF) analysis were retrieved from health records. Results Ninety-two patients with PT were identified during the study period. Among them, 51 (55%) were males. The mean age was 10.9 years old. Twenty-one percent was represented by children aged six years or less. The most common symptoms were fever (88%), cough (72%) and chest pain (70%). The time between the onset of symptoms and diagnosis varied between 2 and 300 days, with a median of 16 days. Unilateral pleural effusion was described in 96% of the cases. Lymphocyte predominance was found in 90% of PF samples. The adenosine deaminase dosage of PF was greater than 40 U/L in 85% of the patients. Prior diagnosis of community acquired pneumonia and antibiotic use were observed in 76% of the cases. Conclusion We suggest consider the diagnosis of PT in children and adolescents with the following characteristics: fever, cough and thoracic pain as presenting symptoms; history of contact with tuberculosis; Mantoux test 10 mm; unilateral pleural effusion; lymphocytes predominance in PF sample; pleural fluid ADA greater than 40 U/L and poor response to antibiotics prescribed for community-acquired pneumonia.
Introduction: The diagnosis of acute viral bronchiolitis (AVB) is primarily based on the findings in pulmonary auscultation.There is no consensus on which auscultatory finding is the most frequent in AVB. This study aims to describe the pulmonary auscultation in a series of patients with AVB and verify its association with age, sex, viral agent, and duration of oxygen therapy. Method: Pulmonary auscultation was recorded in patients hospitalized for AVB between October 2018 and October 2019 using an electronic stethoscope and then parallelly analyzed by two examiners. The effect of other factors such as sex, age, duration of oxygen therapy and etiological agent was analyzed for any possible associations. Results: Of 114 patients, 67 (58.8%) produced wheeze, 43 (37.7%) produced crackles, and 4 (3.5%) had normal auscultation. Wheezing was predominant in male patients while crackling in female patients (67.1% and 52.3%, respectively; p = 0.039). Age had no significant influence on the auscultation pattern (p = 0.054), etiological agent (p = 0.053) and the duration of oxygen therapy (p = 0.877). The median age was higher in patients with parainfluenza compared to those with RSV (6.5 and 4.4 months, respectively; p = 0.044). The duration of oxygen therapy was higher in patients with RSV compared to those with no identified virus (median 5.2 and 2.68 days, respectively; p = 0.018). Conclusions: Wheezing was recorded as the predominant auscultation finding among hospitalized patients with AVB. The type of virus associated with AVB had no influence on the changes in pulmonary auscultation.
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