Paper Title
A Case Report Of Massive Pleural Effusion Caused By Pulmonary Tuberculosis In Paediatrics

Abstract
Background: Pleural effusion in paediatrics is an abnormality frequently develops from the collection of fluids in the pleural space commonly caused by a primary or secondary to variety of disorders such as an infection. One of infection that can caused pleural effusion is Mycobacterium tuberculosis with characterized by an intense chronic accumulation of fluid and inflammatory cells in pleural space. Worldwide, about 530.000 children are affected with Tuberculosis (TB), with those from developing countries accounting for the largest number. Tuberculosis in paediatrics is defined as TB disease in a person less than 15 years old. Patient paediatrics with pulmonary TB and pleural effusion presenting with night sweats, cough, and dyspnea. At present, confirming the diagnosis of TB in paediatric use TB score. Case presentation: A nine-year-old boy came to emergency room (ER) at one of hospital in Jember with complaints hard to breath (dyspnea). His complaint occurs since a day before. He had a fever, cough, night sweats, and decreased of appetite since fifteen days ago. His cough was accompanied by phlegm without blood. He had a family history with pulmonary tuberculosis but had complete treatment for six months and stated cured. There was no delay in patient’s growth and development. From examination, the respiratory rate was increased, the fremitus palpation was decreased on the right side of chest, on percussion was obtained the right chest is dimmer, on auscultation the vesicular sounds of right lung was decreased. To confirmed the diagnosis, chest x-ray radiophotographs, ultrasonography of pleural was showed pleural effusion. And his mantoux test was positive. The patient was performed pleural puncture of the right lung 2 times with total fluid 1500cc. The pleural fluid was analysed in clinical and anatomical pathology examination. The patient was treated by anti-tuberculosis drugs and prednisone as anti-inflammatory drug. Conclusion: we reported a case of massive pleural effusion caused by pulmonary tuberculosis infection in a nine years old paediatric patients. Keywords - Pleural Effusion, Tuberculosis, Anti-Tuberculosis Drugs.