Pleural effusion

Causes

Appropriate Tests

 

Pleural fluid - microscopy and culture (including AFB if appropriate), Protein, Glucose, Lactate dehydrogenase; cytology; flow cytometry for Cell immunophenotyping; Fine needle aspiration biopsy, Lesion biopsy, if indicated.

See also Pleurisy

Malignancy, especially

 

Carcinoma lung

 

Carcinoma breast

See under Breast lesion

Mesothelioma

 

Lymphoma (non-Hodgkin)

 

Hodgkin lymphoma

 

Infection, especially

 

Pneumonia

 

Empyema

See also Lung abscess

Bacterial, especially
  • Staphylococcus aureus
  • Streptococcus pneumoniae
  • Gram-negative rods
  • Anaerobes
  • Polymicrobial
  • Tuberculous

 

 




 

See Tuberculosis

Fungal

Usually associated with penetrating chest injuries.

Parasitic, especially
  • Entamoeba histolytica
  • Paragonimus westermani
  • Filariasis

See Amoebiasis

See under Lung abscess

Connective tissue diseases, especially

SLE

 

Other

 

Cardiac failure

B-Type natriuretic peptide, NT-proBNP.

Hypoalbuminaemia

 

Chylous effusion (thoracic duct trauma/obstruction)

Pleural aspiration usually diagnostic; Triglycerides if diagnosis doubtful.

Acute pancreatitis

See Pancreatitis

Hypothyroidism

 

Haemothorax

 

Meig's syndrome