Prevalence of latent tuberculosis and mycobacterial infections in medicolegal cases with pleural adhesions: An observational study

Objective and Background

Pleural adhesions, fibrous bands between pleural layers, are common in autopsies and often associated with Tuberculosis (TB). This study aims to determine the prevalence of latent TB and mycobacterial infections in medicolegal cases with pleural adhesions. The focus is on various diagnostic approaches and implications of the study for TB management in a high-burden setting like India.

Materials and Methods

The observational study spanned two years, involving 743 autopsies at AIIMS Bhopal. Tissue samples from 82 cases with pleural adhesions were analyzed after obtaining consent and a detailed history. Diagnostic methods, including direct smear microscopy, Mycobacteria Growth Indicator (MGIT), Lowenstein–Jensen (LJ) media, and PCR, were employed.

Observation

Of 164 cases with pleural adhesions, 15 (18.29 %) were positive for Mycobacterium, including 11 MTB and 4 NTM cases. Diagnostic methods revealed the challenges in detecting latent TB. Incidental diagnoses were prevalent, emphasizing the need for heightened awareness. Advanced techniques (MGIT, LJ, PCR) improved detection rates. The study highlights latent TB's impact in India, suggesting the importance of research, surveillance, and interventions for effective TB control. Addressing latent TB becomes crucial in global eradication efforts.

Conclusion

The study emphasizes India's TB burden, with pleural adhesions acting as clinical markers. Incidental diagnoses and the role of latent TB in the population underscore the need for enhanced research and diagnostic strategies. Diagnostic challenges, including limited symptoms, necessitate advanced techniques. The study discusses the multifaceted challenge of latent TB diagnosis and the importance of interventions.