Abstract
Introduction
A pleural effusion is collection of fluid abnormally present in the pleural space, usually resulting from excess fluid production and/or decreased lymphatic absorption presenting with cardiopulmonary symptoms. A systemic approach to the investigations is needed because of the extensive differential diagnosis
A pleural effusion is collection of fluid abnormally present in the pleural space, usually resulting from excess fluid production and/or decreased lymphatic absorption.1 It is the most common manifestation of pleural disease, and its etiologies range in spectrum from cardiopulmonary disorders and/or systemic inflammatory conditions to malignancy. It is one of the major causes of pulmonary morbidity and mortality
Mechanisms by which the rate of fluid formation exceeds the rate of fluid absorption include increased pulmonary capillary pressure or permeability of the endothelial barrier, decreased intra pleural pressure or plasma oncotic pressure, obstructed lymphatic flow, diaphragmatic defects, and thoracic duct rupture.2 Pleural fluid aspiration followed by application of the time-honored Light’s criteria remains a remarkably useful step in the diagnostic algorithm of pleural effusions, although an expanding panel of diagnostic tools in the past decade has slowly transformed our approach to pleural diseases, the increasing complexity of which has motivated the development of multidisciplinary pleural subspecialty programs at many institutions in recent years.3, 4
Worldwide, exudative effusions are usually due to empyema, malignancy, tuberculosis, pulmonary embolism, and connective tissue diseases.5
In our setup, the common causes of exudative pleural effusions are tuberculosis, parapneumonic effusion, and malignancy. In developing nations, infections– especially tuberculosis and parapneumonic effusions, are more prevalent.6
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Corresponding Author
Dr Dinesh Mohan Chaudhari
Resident, Department of General Medicine, S.R.T.R.GMCH Ambajogai (Maharashtra)
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.91
