Pleural effusion - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Pleural effusion predominantly presents with breathlessness, but cough and pleuritic chest pain can be a feature. The etiology of the pleural effusion determines other signs and symptoms.
Posteroanterior chest x-ray will show an effusion of >200 mL of fluid. An ultrasound, chest computed tomography scan, or lateral decubitus study indicates whether the fluid is free-flowing or loculated, and whether or not septations are present.
Aspiration and evaluation of the pleural fluid with biochemistry, cytology, and culture determines the nature of the effusion.
Treatment is based on the nature of the effusion and underlying condition.
Therapeutic thoracentesis with nearly complete removal of the fluid collection alleviates dyspnea and cough in most circumstances.

Left-sided pleural effusion

From the collection of R Light

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Left-sided pleural effusion

Citations

Key Articles

Roberts ME, Rahman NM, Maskell NA, et al. British Thoracic Society Guideline for pleural disease. Thorax. 2023 Jul;78(suppl 3):s1-42.[Full Text]
Rahman NM, Maskell NA, West A, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011 Aug 11;365(6):518-26.[Abstract]

Referenced Articles

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