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Why do I have fluid accumulation in my chest?

Q: I am 23 years old female. I had tuberculosis when I was four years old. It was then cured and I was fine. Some four years back, a patch was detected in my chest along with accumulation of fluid. I got operated and got rid of the patch. Now, just a few days back I had chest pain and after some tests fluid accumulation has been detected again. Why has the fluid accumulated again? What are the chances of its recurrence? Will this affect my chances of conception? Will my children also get infected due to this?

A:Accumulation of fluid in the chest (or pleural effusion) may occur because of a number of infective or non-infective reasons, of which TB/tuberculosis is one. Re-accumulation of fluid in the chest could be due to recurrence of disease (TB) or reinfection (TB). The former is possibly more likely. However, definitive diagnosis will depend on culturing the pleural fluid for the bacteria causing TB (Mycobacterium tuberculosis), and doing other tests (such as TB PCR, cytology of the fluid to rule out other causes). According to some studies, there is approximately 50% chance that the pleural effusion could be due to TB in those with a previous history of TB. In individuals with a current or recurrent TB, it is recommended that underlying defect in immunity be excluded and this should include considering an HIV test. In this case it is important first to establish the cause of pleural effusion. If TB is likely, then with effective anti-tuberculous therapy the chance of cure is high and there should not be any problem in pregnancy if there is no associated involvement of the reproductive organs. Intra-uterine transmission of TB and subsequent congenital TB is a rare phenomenon, and is more likely to occur in pregnant patients with active disease who do not receive effective treatment in time.

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