Adjunct therapy with corticosteroids or paracentesis for treatment of tuberculous pleural effusion

To determine the effect of adjunct therapy, we carried out a prospective cohort study on 190 patients with tuberculous pleural effusion during May 2003–April 2004. Patients were divided into 3 groups. All groups were treated with anti-tuberculosis (TB) drugs for 6 months; in group 2 (n = 46) prednisolone, 30 mg/day for 10 days, was added; group 3 (n = 78) were given paracentesis to remove fluid. Fever and constitutional symptoms disappeared faster in group 2 (P 0.05). After 10 days, there was a significantly greater reduction in the size of pleural effusion in group 2, but after 6 months the difference was not statistically significant. We found corticosteroids and therapeutic paracentesis are not necessary in the management of TB pleural effusion.