The presentation of TB in elderly patients differs from that of younger patients in symptomatology. A high index of suspicion is therefore required to make a timely diagnosis of TB in the elderly.

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Background: Approximately 15% to 20% of tuberculosis (TB) cases in India are estimated to have extrapulmonary tuberculosis, and tuberculous effusion being the second most common extrapulmonary manifestation after tuberculous lymphadenitis. Due to its paucibacillary nature, it is difficult to demonstrate tubercle bacilli by the standard staining procedures which is the gold standard for diagnosis, thus leading to a large number of cases being undiagnosed or misdiagnosed. Now, it has further been complicated by the emergence of multidrug resistance. In December 2010, World Health Organization endorsed the Gene Xpert MTB/RIF technology for diagnosis of mycobacterium tuberculosis and rifampicin resistance which is providing result within 2 hour. Aims: This study was done with an aim to know the role of Gene Xpert in the diagnosis of tubercular pleural effusion. Results: A total of 136 patients of pleural effusion with strong clinico-radiological and pathological suspicion of tubercular etiology were included in our study and their pleural fluid was examined for Gene Xpert MTB/RIF. In 20.58%(28) patients, Mycobacterium tuberculosis was detected and out of these, 21%(6) had rifampicin resistance. Conclusion: Because of its rapidity, simplicity, and sensitivity, Gene Xpert MTB/RIF technology is emerging as a novel and promising technique to diagnose tuberculous effusion and rifampicin resistance, which was undiagnosed most of the time. Although, it has limited availability at present, and for this more research studies should be conducted.

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