Gene Xpert MTB / RIF – Diagnostic Role in Tuberculous Pleurisy

Background: Tuberculous pleurisy is a common extrapulmonary manifestation and is second to tuberculous lymphadenitis. Due to its paucibacillary in origin, its diagnosis is a challenge. Furthermore, it is also complicated by the emergence of MDR. Gene Xpert MTB/RIF is a new rapid promising innovation for the detection of mycobacterium tuberculosis and its resistance to Rifampicin, giving result within two hours. Objective: To evaluate the diagnostic role of Gene Xpert MTB/RIF in suspected cases of tuberculous pleurisy. Study Design: Cross sectional study. Study Setting: Institute of Chest Medicine Mayo Hospital – a Tertiary Care Hospital affiliated with King Edward Medical University, Lahore. Methodology: The study group, one hundred (M-60 and F-40) cases having exudative, predominantly lymphocytic pleural effusion with strong suspicion of tuberculous in origin were enrolled randomly for Gene Xpert MTB / RIF. Results: Among one hundred study cases, Gene Xpert detected mycobacterium tuberculosis in 12(12%) cases [M-8 (13.3%) and F-4 (10%)]. Resistance to Rifampacin was detected in 6 (6%) cases [M-2 (3.3%) and F-4 (10%)]. Conclusion: Gene Xpert MTB/RIF is a useful new rapid promising technique to diagnose tuberculous pleurisy. Although at present it has limited availability and utility.