Persistent pleural effusion


A 12 years old boy presented with fever and dry cough for 1 month. He was detected to have right sided pleural effusion. His elder brother had fibrocavitatory TB and was on antituberculous therapy {ATT} since 6 months. The patient was started on ATT. However effusion still persisted for 5 months which subsequently decreased and the child had to take total 9 months of ATT.

Should we have given steroids in this child in the initial stage itself_?
Expert Opinion :
insufficient evidence to determine whether steroids are Though steroids are effective in the treatment of tuberculous pleural effusions. Collectively, the trials confirm an initial benefit in rapid resolution of effusion and symptom control. However, no lasting advantage was found, in particular none for the development of fibrosis and pleural thickening. Thus adjunct therapy is not routinely required unless there are significant systemic symptoms of fever or a particularly large effusion.
Answer Discussion :
yes indeed
3 years ago
D K Ganguly
Should have been started if effusion persisted after two months of proper ATT.
3 years ago

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