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Pleural Effusion is a medical condition that deals with the space around the Lungs that can lead to a difficulty in breathing and other symptoms.

Typically occurs when an abnormally large amount of fluid is found in the pleural cavity, the space around the lungs.

The fluid in the pleura can prevent expansion of the lungs.

5 Types of Effusions – divided based on type of fluid.

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
• Meigs 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