Tuberculous pleurisy
Chapter 1:Certain infectious and parasitic diseases
ICD-10 A15.6 is a billable code used to indicate a diagnosis of tuberculous pleurisy.
Tuberculous pleurisy is a form of extrapulmonary tuberculosis characterized by the presence of tuberculosis bacteria in the pleural space, leading to inflammation of the pleura. This condition often arises as a complication of pulmonary tuberculosis but can occur independently. Patients typically present with symptoms such as pleuritic chest pain, cough, fever, and dyspnea. Diagnosis is confirmed through a combination of clinical evaluation, imaging studies like chest X-rays or CT scans, and laboratory tests including sputum smear and culture for Mycobacterium tuberculosis. In some cases, pleural fluid analysis via thoracentesis may be necessary to identify the presence of tuberculous infection. Treatment primarily involves a multi-drug regimen of antitubercular medications, typically including isoniazid, rifampicin, ethambutol, and pyrazinamide, administered for an extended period, often six months or longer. Monitoring for drug resistance is crucial, as multidrug-resistant tuberculosis (MDR-TB) poses significant treatment challenges. Public health measures, including contact tracing and isolation of infectious patients, are essential to control the spread of tuberculosis in the community.
Detailed clinical notes on symptoms, diagnostic tests, and treatment plans.
Patients presenting with respiratory symptoms and a history of tuberculosis exposure.
Ensure thorough documentation of imaging studies and laboratory results to support coding.
Comprehensive records of patient history, treatment regimens, and follow-up care.
Management of patients with drug-resistant tuberculosis or those requiring specialized treatment.
Documenting public health interventions such as contact tracing and isolation protocols.
Used to obtain pleural fluid for analysis in suspected tuberculous pleurisy.
Document indication for procedure, fluid analysis results, and patient response.
Pulmonologists should ensure thorough documentation of the procedure and follow-up care.
Common diagnostic tests include sputum smear and culture for Mycobacterium tuberculosis, chest X-rays, CT scans, and pleural fluid analysis obtained via thoracentesis.
Drug resistance is monitored through culture and sensitivity testing of the Mycobacterium tuberculosis strain, as well as by assessing patient adherence to the prescribed treatment regimen.
Public health measures include contact tracing, isolation of infectious patients, and ensuring that patients complete their treatment to prevent the spread of tuberculosis.
