{
  "abstract": "Background\n\nDrug-resistant tuberculous pleurisy is difficult to diagnose in children because pleural fluid is paucibacillary, culture is slow and frequently negative, and Xpert detects only rifampicin resistance.Case presentation\n\nWe report two children in whom thoracoscopic pleural biopsy combined with PCR-high-resolution melting (HRM) drug-resistance testing identified drug-resistant tuberculosis. Case 1, an 8-year-old girl with tuberculous pleurisy, showed persistent pleural thickening and a new mass after two months of standard first-line therapy; pleural tissue PCR detected rpoB and inhA mutations, confirming multidrug-resistant tuberculosis (MDR-TB), and she responded to an all-oralbedaquiline- and delamanid-containing regimen. Case 2, a 9-year-old boy with loculated tuberculous pleurisy and negative cultures, had an rpoB mutation confirming rifampicin-monoresistant tuberculosis; he recovered with a rifampicin-sparing regimen and remained relapse-free at one year.Conclusion\n\nIn pediatric tuberculous pleurisy, particularly when fluid-based testing is uninformative or first-line therapy fails, thoracoscopic pleural biopsy combined with molecular drug-resistance testing of tissue is decisive for detecting occult drug-resistant tuberculosis and enabling timely, individualized treatment.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu,People's Republic of China.",
    "Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu,People's Republic of China."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yunlian Huang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Qin Guo"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yiyuan Li"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Fangyong Jiang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ruoxi He"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yu Zhu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0zrnhjtdnr2t1.bib",
  "cited_by": 0,
  "doi": "10.2147/idr.s653638",
  "fulltext_url": "https://europepmc.org/articles/PMC13685689",
  "id": "0zrnhjtdnr2t1",
  "issns": [
    "1178-6973"
  ],
  "landing_url": "https://europepmc.org/article/MED/42910207",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|Tuberculosis Research and Epidemiology"
    ]
  ],
  "openalex": "W7222565548",
  "pdf_url": "https://europepmc.org/articles/PMC13685689?pdf=render",
  "pmcid": "PMC13685689",
  "pmid": "42910207",
  "published": "2026-10-17",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/0zrnhjtdnr2t1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42910207",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42910207"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Tuberculosis Research and Epidemiology",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Two Case Reports of Drug-Resistant Tuberculous Pleurisy in Children: Thoracoscopic Pleural Biopsy and PCR-Based Drug-Resistance Testing.",
  "title_text": "Two Case Reports of Drug-Resistant Tuberculous Pleurisy in Children: Thoracoscopic Pleural Biopsy and PCR-Based Drug-Resistance Testing.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/0zrnhjtdnr2t1",
  "venue": "Infection and drug resistance",
  "versions": []
}