Treatment of Tuberculous Pleural Effusion with Local Instillation of Hydrocortisone

¹ Department of Medicine, Sarojini Naidu Medical College

Seventy-seven patients with tuberculous pleural effusion have been treated with intrapleural hydrocortisone in addition to usual antituberculosis drugs. This was repeated at fortnightly intervals if the fluid did not absorb. The results have been compared with 25 unselected cases who were given antituberculosis drugs alone.

In the hydrocortisone group, striking response was obtained in 60 cases (77.9 per cent) wherein the fluid disappeared after one instillation of hydrocortisone within a fortnight. A good response was seen in ten cases (13 per cent) in whom two administrations of hydrocortisone at fortnightly intervals were needed. A fair response in three cases and an unsatisfactory response in four cases were observed since the fluid took two months or longer to absorb. The results were strikingly better than in the control group where unsatisfactory response was observed in 64 per cent of cases.

The response to local hydrocortisone was not related to level of effusion or its duration.

In the hydrocortisone group there was no complication and minimal residual pleural thickening was seen in only ten cases.