Highly Elevated Adenosine Deaminase Level in Brucellar Pleural Effusion

Pleural involvement is a rare presentation of brucellosis. There are only a few case reports in the literature presenting with pleural involvement due to brucellosis. In this report, we present a case with exudative pleural fluid first considered as tuberculous pleurisy due to lymphocyte predominance and elevated level of pleural adenosine deaminase, but later diagnosed as brucella pleurisy with positive serologic and microbiologic test results. In conclusion, in the differential diagnosis of pleurisies, routine serologic and bacteriologic methods appear to be more important than pleural adenosine deaminase elevation, especially in regions endemic for both tuberculosis and brucellosis.