Bilateral tubercular pleural effusion- a rare presentation

Tuberculous pleural effusion is the second most common form of extra pulmonary tuberculosis and is the most common cause of pleural effusion in areas where tuberculosis is endemic. Over 95% of pleural effusion are unilateral. However, cases of bilateral pleural effusion have been reported. Diagnosis is challenging since 48-96% of tuberculous pleural effusion is negative for sputum AFB stain and culture. The following case illustrates the clinical presentation and diagnostic approach in a case of suspected bilateral tuberculous pleural effusion in a 40-year-old male.