Presentation
Patients with anaerobic pleuropulmonary infection may present with a more insidious course and present with weight loss, fever, and chronic cough. A history of aspiration and poor oral hygiene is often evident. [cancertherapyadvisor.com]
Pleural effusion as a form of presentation of temporal arteritis. Br J Rheumatol, 37 (1998), pp. 203-802 [152] H. Gur, M. Ehrenfeld, E. Izsak. Pleural effusion as a presenting manifestation of giant cell arteritis. [archbronconeumol.org]
In transudative effusion, specific gravity is below 1.015 and less than 3 g/dL of protein is present. [quizlet.com]
[…] an uncommon initial presentation of rheumatoid pleuritis prior to the onset of RA joint symptoms. [racgp.org.au]
Pleural effusion is a common presentation for many pulmonary and systemic diseases, and it is estimated that each year 1.5 million people develop a pleural effusion in the USA and 200 000–250 000 in the UK [ 1, 2 ]. [err.ersjournals.com]
Entire Body System
- Recurrent Pleural Effusion
Chest tube placement (tube thoracostomy): Sometimes a chest tube may need to be placed in the pleural effusion, e.g. with bad infections or recurrent pleural effusions. Surgery : This can be performed for diagnostic or therapeutic purposes. [hospitals.aku.edu]
It is also known as pleural fluid aspiration or a pleural tap In some cases, the fluid keeps accumulating despite being drained periodically, which is called Recurrent Pleural Effusion. [dovemed.com]
In cases of recurrent pleural effusion, chemical pluerodesis (e.g. with tetracycline, talc or bleomycin ) may be useful. [almostadoctor.co.uk]
Regardless of diagnosis, if pleural effusions persist or recur regularly, a patient may face a worse prognosis than those whose effusions are able to be treated without recurrence. [mesothelioma.com]
Management decisions should be taken by the multidisciplinary team on an individual patient basis but should primarily focus on symptom control by prevention of recurrent pleural effusions. Conflict of interest: None declared. [academic.oup.com]
- Sepsis
The potential complications associated with pleural effusion are: lung scarring, pneumothorax (collapse of the lung) as a complication of thoracentesis, empyema (a collection of pus within the pleural space), and sepsis (blood infection) sometimes leading [medicinenet.com]
[…] a respiratory physician is indicated in the presence of a suspected unilateral exudative pleural effusion or a unilateral transudative effusion that respond poorly to treatment. 4 Other red flag indicators include lung or pleural masses on imaging, sepsis [racgp.org.au]
Clinically, five of them were in sepsis. They were put in the category of undetermined etiology for want of a better term. [lungindia.com]
However, untreated or inappropriately treated parapneumonic effusions may lead to empyema, constrictive fibrosis, and sepsis. [emedicine.medscape.com]
- Anemia
All categories except hemothorax showed evidence of anemia - the lowest mean Hb values being in patients of undetermined etiology. [lungindia.com]
Respiratoric
- Pleural Effusion
Diagnosing a pleural effusion A chest X-ray can usually confirm a pleural effusion. However, if doctors know the reason for the pleural effusion they may not need to carry out any more tests. [medic8.com]
Image: Pleural Effusion PLEURAL EFFUSION DIAGNOSIS There are several tests used to diagnose a pleural effusion. [medicalook.com]
Pleural Effusion Recently Answered 2 Answers A A pleural effusion occurs when the pleural fluid that lubricates the surfaces of the pleura (the lining around the organs in the chest) builds up to abnormal, excessive amounts. [sharecare.com]
The other is exudative pleural effusion, caused by tumours, infection/inflammation and lung injury. Pleural effusion may often be asymptomatic. [hospitals.aku.edu]
- Aspiration
The preferred site for aspiration (see figure1) should either be within the triangle of safety bordered by: The anterior border of latissimus dorsi The lateral border of pectoralis major The superior border of the 6th rib Diagnostic aspiration A 21 G [rcemlearning.co.uk]
If it doesn't, continue with pleural aspiration, as below. If NO, perform pleural aspiration. See separate Pleural Effusion Aspiration article. Ultrasound-guided pleural aspiration may be needed if the effusion is small or loculated. [patient.info]
Can be removed by needle aspiration (same method as diagnosis), or chest drain. If aspirating, don’t drain more than 1L at a time. Typically used for emypema and haemothorax. [almostadoctor.co.uk]
Prior to performing an aspiration, the physician must decide whether a diagnostic aspiration alone should be performed or combined with a therapeutic procedure for symptom relief. [academic.oup.com]
Ultrasound guidance is preferred when aspirating fluid. Routine assays for aspirated fluid include protein and lactate dehydrogenase levels, Gram staining, cytology, and pH measurement. [aafp.org]
- Pleuritic Pain
Many cause dyspnea, pleuritic chest pain, or both. Pleuritic chest pain, a vague discomfort or sharp pain that worsens during inspiration, indicates inflammation of the parietal pleura. [msdmanuals.com]
Chest pain occurs because the pleural lining of the lung is irritated. The pain is usually described as pleuritic, defined as a sharp pain, worsening with a deep breath. [emedicinehealth.com]
Pulmonary embolism (tends to produce a comparatively small effusion but disproportionate dyspnoea and pleuritic pain; 80% are exudates, 20% are transudates). Rare causes: Superior vena cava obstruction (usually due to lung cancer). [patient.info]
The distribution of BMI, symptoms of cough, fever, pleuritic pain, and modified medical research council (MMRC) grade of dyspnea did not follow any distinct pattern in the different etiologic categories. [lungindia.com]
- Painful Cough
If you are experiencing chest pain, coughing, shortness of breath or difficulty in breathing, visit your doctor immediately. These symptoms might indicate an underlying problem that requires immediate medical attention. [hospitals.aku.edu]
Symptoms Chest pain Cough that doesn't go away Coughing up blood Fatigue Losing weight without trying Loss of appetite Shortness of breath Wheezing Other symptoms that may also occur with lung cancer, often in the late stages: Bone pain or tenderness [naps-ga.com]
- Abnormal Breathing
The condition is typically observed in individuals with some pre-existing lung conditions such as an injury, tumor, or infection Pleural Effusion may result in chest pain, abnormal breathing, cough and fever. in case of complications, empyema and pneumothorax [dovemed.com]
Gastrointestinal
- Hiccup
See All 2 Answers 2 Answers A The symptoms of pleural effusion include: Chest pain that worsens with coughing or deep breathing Coughing Fever Hiccups Rapid breathing Shortness of breath See All 2 Answers 2 Answers A Treatment for pleural effusion involves [sharecare.com]
[…] of hiccups that do not go away may also be experiencing pleural effusion. [medicalnewstoday.com]
meaning that you simply cannot expand your chest as much as you usually would for comfortable breathing; Cough; Diminished breath sounds, meaning that a doctor would hear shallow breathing; Rapid breathing; Gastric discomfort; Persistent hiccups [medicalook.com]
When symptoms are present, they can include chest pain, difficult or painful breathing (especially deep breathing), coughing, fever, chills, loss of appetite, and hiccups. [study.com]
When present, symptoms include: Chest pain Coughing Shortness of breath Fever Difficulty in breathing Hiccups As mentioned, a pleural effusion is usually caused by an underlying condition such as heart failure, pneumonia, cancer or liver disease, so symptoms [hospitals.aku.edu]
- Vomiting
Coughing and vomiting. Pathophysiology Fluid accumulation in pleural space → lung lobes unable to expand → dyspnea. True transudates associated with hypoproteinemia. [vetstream.com]
[…] viral hepatitis; ascites, caput medusae, palmar erythema Esophageal perforation Exudative History of esophageal tumor or reflux; chest or abdominal pain, fever Pancreatitis Exudative Abdominal pain, anorexia, elevated amylase and lipase levels, nausea, vomiting [aafp.org]
- Nausea
[…] pain Pulmonary vein stenosis Exudative Recent heart catheterization Superior vena cava obstruction Transudative Facial swelling and ruddy complexion, upper extremity swelling Gastrointestinal Abdominal abscess Exudative Abdominal pain, chills, fever, nausea [aafp.org]
- Diarrhea
Other diseases include infection (urinary tract, line infection, peritoneal abscess), neurologic disorders such as cerebrovascular accident, intracerebral hemorrhage, hypertensive encephalopathy; gastrointestinal diseases including acute liver failure, diarrhea [omicsonline.org]
Fetus
- Hydrops Fetalis
A higher incidence of chylothorax is seen in children with Down syndrome, Noonan syndrome, extralobar sequestration, diaphragmatic hernia, hydrops fetalis, and/or pulmonary hypoplasia. [emedicine.medscape.com]
Musculoskeletal
- Arthritis
Arthritis Rheum 2009;61:108-18. [Table 1] [jacpjournal.org]
The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Reum, 31 (1988), pp. 315-324 [7] L. Klareskog, A.I. Catrina, S. Paget. Rheumatoid arthritis. Lancet, 373 (2009), pp. 659-672 [8] M. [archbronconeumol.org]
Question 3 What are the pulmonary complications of rheumatoid arthritis? Table 1. [racgp.org.au]
Some types of arthritis, including rheumatoid arthritis: these conditions can cause the pleura to become inflamed. [medic8.com]
Most common causes include heart failure, coronary heart surgery, pleurisy, bacterial infections such as pneumonia, lung cancer, lymphoma, autoimmune disorders including rheumatoid arthritis and pulmonary embolism or blood clots in the lung blood vessels [livestrong.com]
Workup
[…] embolism. 4 Because many diseases affecting different organs can cause a pleural effusion, we cannot overemphasize the importance of a thorough history and physical examination to uncover clues that will help identify its cause and narrow the diagnostic workup [mdedge.com]
II, C: “ Two or more diagnoses that equally meet the definition for principal diagnosis : In the unusual instance when two or more diagnoses equally meet the criteria for principal diagnosis as determined by the circumstances of admission, diagnostic workup [hcpro.com]
X-Ray
- Chest X-Ray Abnormal
Home » Tutorials » Chest X-ray Tutorials » Chest X-ray Abnormalities » Introduction » 1 2 3 4 5 6 7 8 9 10 11 » Conclusion Key points The pleura and pleural spaces are only visible when abnormal There should be no visible space between the visceral and [radiologymasterclass.co.uk]
- X-Ray Abnormal
Home » Tutorials » Chest X-ray Tutorials » Chest X-ray Abnormalities » Introduction » 1 2 3 4 5 6 7 8 9 10 11 » Conclusion Key points The pleura and pleural spaces are only visible when abnormal There should be no visible space between the visceral and [radiologymasterclass.co.uk]
Pleura
- Pleural Effusion
Diagnosing a pleural effusion A chest X-ray can usually confirm a pleural effusion. However, if doctors know the reason for the pleural effusion they may not need to carry out any more tests. [medic8.com]
Image: Pleural Effusion PLEURAL EFFUSION DIAGNOSIS There are several tests used to diagnose a pleural effusion. [medicalook.com]
Pleural Effusion Recently Answered 2 Answers A A pleural effusion occurs when the pleural fluid that lubricates the surfaces of the pleura (the lining around the organs in the chest) builds up to abnormal, excessive amounts. [sharecare.com]
The other is exudative pleural effusion, caused by tumours, infection/inflammation and lung injury. Pleural effusion may often be asymptomatic. [hospitals.aku.edu]
Treatment
In some cases, draining the pleural effusion may be sufficient treatment but if the underlying illness cannot be treated effectively, the effusion is likely to return and therefore other treatments may be recommended. [medic8.com]
PLEURAL EFFUSION TREATMENT Even with treatments available, complications do sometimes arise if you suffer from a pleural effusion. If a lung is surrounded by fluid for a prolonged amount of time, that lung may collapse. [medicalook.com]
Further treatments, depending on the cause of the effusi on, include: Surgery Radiotherapy (using high-powered X-rays or other radioactive particles to kill cancer cells) Chemotherapy (treatment used to kill cancer cells) Injecting medication into the [hospitals.aku.edu]
You may need this treatment more than once if fluid builds up again. Other treatments may be necessary to manage fluid buildup if cancer is the cause of the pleural effusion. [healthline.com]
Once we've approved your claim, you'll get the private treatment you need. 3 And we’ll pay for treatment After you've been treated, send us your invoices. [aviva.co.uk]
Prognosis
Prognosis In patients with pleurisy, the outlook depends on the underlying medical illness. Lung infection — People with epidemic pleurodynia or other viral cause of pleurisy have an excellent prognosis. [drugs.com]
(Outcomes/Resolutions) The prognosis of Pleural Effusion depends upon the underlying cause If the underlying cause is detected promptly and appropriately managed, the outcome is better Additional and Relevant Useful Information for Pleural Effusion: A [dovemed.com]
Prognosis of Pleural Effusion Prognosis for patients with pleural effusions varies based on the underlying condition causing the retention of pleural fluids. [mesothelioma.com]
Pleural effusion in MM normally indicates a poor prognosis for myeloma and a low possibility of survival. Pleural effusion is seen in only few patients with myeloma. [casereports.in]
The presence of a malignant pleural effusion is associated with a poor prognosis with median survival following diagnosis ranging from 3 to 12 months depending on cell type. [ 1 ] [patient.info]
Etiology
To treat pleural effusion appropriately, it is important to determine its etiology. However, the etiology of pleural effusion remains unclear in nearly 20% of cases. Thoracocentesis should be performed for new and unexplained pleural effusions. [dovepress.com]
No etiologic diagnosis could be established in 6 (12%) patients and their etiology was categorized as "undetermined." [lungindia.com]
A cell count may also reveal an underlying etiology. [aafp.org]
The etiology is usually unknown, but heart failure, lymphoma, heart worm infection and lymphangiectasia are sometimes implicated. Timecourse Acute. Insidious and progressive. [vetstream.com]
Drugs Drugs used in pleural effusion depends on the condition’s etiology. [medcaretips.com]
Epidemiology
Epidemiological differences among pneumococcal serotypes. Lancet Infect Dis. 2005 Feb. 5(2):83-93. [Medline]. Byington CL, Korgenski K, Daly J, Ampofo K, Pavia A, Mason EO. [emedicine.medscape.com]
Merchant JA (1990) Human epidemiology: a review of fiber type and characteristics in the development of malignant and nonmalignant disease. Environ Health Perspect 88:287-93 46. [mhlw.go.jp]
Epidemiology of the vasculitides. Rheum Dis Clin North Am, 27 (2001), pp. 729-749 [147] C. Salvarani, F. Cantini, L. Boiardi, G.G. Hunder. Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med, 347 (2002), pp. 261-271 [148] T.S. Larson, S. [archbronconeumol.org]
Pathophysiology
Chest 121:2079–2080 PubMed CrossRef Google Scholar Miserocchi G (1997) Physiology and pathophysiology of pleural fluid turnover. [link.springer.com]
Pathophysiology Fluid accumulation in pleural space → lung lobes unable to expand → dyspnea. True transudates associated with hypoproteinemia. [vetstream.com]
This article reviews the pathophysiology of MPE along with available investigations and management strategies for these patients. [academic.oup.com]
Pathophysiology of malignant pleural effusion7 The tumours most commonly associated with pleural effusion are lung, breast, lymphoma and tumours of the GI tract. Tumour cells migrate to the pleura by either haematogenous or lymphatic spread. [rcemlearning.co.uk]
Image Credit: Wikipedia Pathophysiology and Causes of Pleural Effusion The normal pleural space contains approximately 10 mL of fluid, representing the balance between Hydrostatic and oncotic forces in the visceral and parietal pleural vessels Extensive [medcaretips.com]
Prevention
If congestive heart failure is the cause, diuretics may be used to prevent fluid buildup. Other medicines also may be used to treat heart failure. [sharecare.com]
Prevention In some cases, you can prevent pleurisy by preventing the medical condition that causes it. For example, some types of pneumonia can be prevented by vaccination. [drugs.com]
Pleural Effusion Prevention Pleural effusions are caused by a variety of conditions and illnesses. Preventing the underlying cause will decrease the potential of developing an effusion. [emedicinehealth.com]