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Eosinophilic pleural effusion with eosinophilia of peripheral
blood
Å. Perrakis1, P. Lambrou1,
Ek. Chaniotou1, Í. Markou1,
Å. Tassiopoulou1,
S. Savva2, Í. Anastassiou3,
Á. Damianos1
SUMMARY: A 41 year-old man was admitted to our Hospital because of
pleuritic chest pain and mild fever (37,4 °C). He had no medical history. He
had been treated with roxythromycin for the preceding ten days. Routine physical
examination revealed dullness and decreased breath sounds over the basal part
of the right hemithorax. His labaratory data revealed leukocytosis with hypereosinophilia.
At initial thoracentesis, an exudative effusion containing 54% eosinophils was
documented with simultaneous peripheral eosinophilia of 35%. Values for the
remainder of his labaratory studies were within normal range. There were no
nuclear antibodies and no rheumatic factor; screening for parasites, bacteria,
mycobacteria and malignant cells was negative. Tuberculin skin reaction was
positive (19 mm). Chest radiography showed moderate accumulation of fluid in
the right pleural space. Computed tomographic films of the thorax showed pleural
effusion in both lungs with no hilar or mediastinal lymph node enlargement.
The patient underwent video-assisted-thoracic surgery (VATS) procedure to establish
a diagnosis. Histologically there were lesions that formed granulomas. Antituberculous
therapy was adninistered and six months later a new X-ray was normal. Conclusion:
Pleural fluid eosinophilia does not exclude the diagnosis of tuberculous pleuritis.
Pneumon 2003, 16(2):215-220.
Key words: Eosinophilia, pleural effusion.