An Asymptomatic Haemorrhagic Pleural Effusion Mimicking Extra-Pulmonary Tuberculosis in a Young Woman with Thoracic Endometriosis Syndrome: A Case Report

Background: This case discusses the importance of thoroughly investigating a haemorrhagic effusion in a setting where the tuberculosis is endemic. Case report: A young woman presented with an asymptomatic recurrent right sided pleural effusion. Pleural fluid full report showed neutrophilic and haemorrhagic effusion. Adenosine deaminase level in the pleural fluid was elevated and the Mantoux test was positive. Microbiological diagnosis was negative, and she was started on anti-tuberculous therapy on clinical grounds for extrapulmonary tuberculosis. Diagnostic Thoracoscopy revealed characteristic appearance suggestive of thoracic endometriosis which was confirmed by histology. Conclusions: Thoracoscopy is valuable in rapid diagnosis of pleural based diseases such as thoracic endometriosis. It also provides option to drain tuberculous and other complicated effusions completely minimising the chance of later complications. This case discusses the importance of thoroughly investigating a haemorrhagic effusion in a setting where the tuberculosis is endemic.