ADA and Pleural effusion: The patient had previously been admitted to a government hospital in Central India, where investigations revealed elevated total leucocyte counts and pleural effusion. Pleural fluid microscopy also showed a total leucocyte count of approximately 12,000-13,000 cells/cumm with neutrophils 85% and lymphocytes 15%, and ADA (adenosine deaminase) 28.8. The patient received intravenous antibiotic treatment; however, her health did not improve, and she was subsequently transferred to our hospital for more intensive treatment.