It is seen when an abnormally large amount of fluid in the pleural cavity.
This is the space that surrounds the lungs and can lead to a difficulty in breathing and other symptoms.
The fluid in the lungs or pleura can prevent expansion of the lungs.
Typically divided depending on cause and fluid substance:
1. Transudates - Fluid seeps in from capillaries – an increase of normal fluid
2. Exudates I - Abnormal fluid from capillaries
3. Exudates II – Inability to get rid of fluid
4. Empyema - Infection into plural space – typically a milky substance [Pus]
5. Hemothorax – Fluid with an amount of blood
Symptoms
- Difficulty breathing [Dyspnea]
- Pain with breathing
- Cough
- Chest pain or pressure
- Shortness of breath
- Rapid breathing
- Sometimes, no symptoms can be seen.
Causes
1.) Transudates
· Heart Failure – most common cause
· Cirrhosis
· Pulmonary Embolism
· And others
2.) Exudative
· Pneumonia
· Lung Cancer
· Breast Cancer
· Lymphoma
· Other bacterial infections
· Viral infections
· Pulmonary embolism
· Tuberculosis
· Autoimmune diseases
· Meig’s syndrome
· And others
Diagnosis
Chest X-ray is very important showing abnormally large amount of fluid
Thoracentesis is required to determine type of fluid (Needle into pleural cavity)
Culture analysis of fluid along with protein, glucose, white blood cell counts, etc.
Ultrasound may be helpful for thoracentesis
Treatment
Transudative Pleural Effusion
· Treat underlying condition
Malignant Pleural Effusion
· Pleuodesis – an irritant is placed into pleural cavity
· Doxycycline – an irritant
· Talc – an irritant [Asbestos-free and sterile]
Bacterial Pneumonia Pleural Effusions
· Azithromycin
· Penicillin
· Other antibiotics
· Drainage when more complicated
· Streptokinase
· Urokinase
Hemothorax
· Observation only if small
· Drainage if more complicated