Unilateral Massive Pleural Effusion Occupying the whole Hemithorax Due to Tuberculosis; a Rare form of Pleural Tuberculosis: a Case Report

Introduction: Tuberculous pleural effusions are usually unilateral, small to moderate in size, usually occupying less than two-thirds of the hemithorax. Massive pleural effusion as a result of tuberculosis is rare. Case presentation: A-65-year-old male patient from Ethiopia came with a four-month history of productive cough and constitutional symptoms. Physical examination showed malnourished patient with evidence of massive left side pleural effusion; sputum Gene X-pert was positive for Mycobacterium tuberculosis, Chest X-ray demonstrated massive left side pleural effusion occupying the whole left hemithorax with trachea shifted to the right. Pleural fluid analysis was remarkable for lymphocytic effusion with a high protein and a negative cytology for malignant cells upon repeated testing. Conclusion: Massive pleural effusion as a result of tuberculosis is a rare presenting way of pleural tuberculosis. Delay in diagnosis leads to catastrophic complications with significant morbidity and mortality.