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June 6, 1977

Pleural Effusion-Reply

JAMA. 1977;237(23):2469-2470. doi:10.1001/jama.1977.03270500021006

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Our survey consisted entirely of adults. The age range was 27 to 79 years, and although the majority were over 50 years, there were several between the ages of 35 and 50 years.

We're certain that Dr Stead would agree with us that tuberculosis is still a very active problem in American medicine, and we sincerely hope that our article will not cause physicians to overlook this disease as a cause for pleural effusion, no matter what the patient's age. This is why we recommended a culture for Mycobacterium in all effusions in which the physician has no idea of the cause. However, we also feel that there are several clinical situations in which the chance of the effusion being the result of tuberculosis must be less than 1%. It is in these situations that we feel a culture for tuberculosis is a very low-yield procedure and may