yemenjmedYemen Journal of MedicinecoVolume 5 Issue 1MultidisciplinaryEnglishJanuary- April 2026NNY20260430ArticleMesothelial Cell–Rich Tuberculous Pleuroperitoneal Effusion in an Immunocompetent Patient: A Diagnostic PitfallEnglishY211214Theeb OsamaSulaiman1EnglishNEbtihal AbdelmoneimHassan2EnglishY10.63475/yjm.v5i1.0312Tuberculous pleural effusion typically presents as an exudative effusion characterized by lymphocytic predominance and a notable scarcity of mesothelial cells, with studies confirming that pleural fluid from tuberculous patients rarely contains more than 5% mesothelial cells. We present a case of an immunocompetent patient who presented with concurrent ascites and rightsided exudative pleural effusion, both featuring elevated mesothelial cell counts. This finding represents a diagnostic pitfall, as high mesothelial cell counts often divert clinical suspicion toward malignancy or acute pleuritis rather than infection. Subsequent investigations, including peritoneal biopsy, confirmed the diagnosis of tuberculosis. The patient was started on antituberculousEnglishTuberculosis, tuberculous pleural effusion, mesothelial cells, ascites, diagnostic pitfallhttps://yemenjmed.com/admin/abstract?id=393References1619