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Pleural Effusion

Effusions Pleural


Presentation

  • Myeloma presenting with a pleural effusion is rare and reported in only 6% of patients with myeloma. Such patients generally present late and have a poor prognosis.[ncbi.nlm.nih.gov]
  • It is present in various forms but its manifestation as pleural effusion is rare. Here, we describe a case of 58-year-old male who presented with complaint of left side chest pain and breathlessness.[ncbi.nlm.nih.gov]
  • We report the first case of chronic eosinophilic pneumonia presenting with pneumonia with ipsilateral transudative eosinophilic pleural effusion.[ncbi.nlm.nih.gov]
  • Although lymphangioma is a rare patient condition, it should be included in the differentials for patients presenting with pleural effusions.[ncbi.nlm.nih.gov]
  • Abstract Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following ovulation induction therapy.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Pleural effusion with MM was caused by congestive heart disease, chronic renal failure, hypoalbuminemia, pulmonary infarctions, cirrhosis, pulmonary arterial hypertension, parapneumonic effusion, tuberculous pleural effusion, and myelomatous pleural effusion[ncbi.nlm.nih.gov]
  • Although pleural effusion is a common complication of maintenance hemodialysis, few reports have documented the use of pleuroperitoneal shunt to control refractory pleural effusion.[ncbi.nlm.nih.gov]
  • Pleural disease Empyema Heart failure Pulmonary embolism Subpulmonic effusion Thoracentesis MedlinePlus Encyclopedia Pleural Effusion Pleural Effusion Images from MedPix[en.wikipedia.org]
  • effusion Loculated pleural effusion Pleural effusion Pleural effusion (fluid around lung) Secondary pleural effusion Clinical Information A disorder characterized by an increase in amounts of fluid within the pleural cavity.[icd9data.com]
  • The diagnostic yield of medical thoracoscopy for tuberculous pleural effusion was 91.4%. Malignant pleural effusions accounted for 5.2% of cases. Minor bleeding occurred in 1.2% of cases with no procedure-related mortality observed.[ncbi.nlm.nih.gov]
Cough
  • Symptoms include shortness of breath, cough, and chest pain.[icd9data.com]
  • We report a 22-year-old woman who presented to the Emergency Medicine Department of the Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with an eight-day history of fever associated with coughing, chills and rigors.[ncbi.nlm.nih.gov]
  • This person may actually have a cough as well, and the type of cough that we can expect to see would be a dry cough versus a wet cough.[khanacademy.org]
  • We herein reported a case of a 14-year-old female patient who was admitted to our center with a history of cough for 1 and a half months and right chest pain for 1 month.[ncbi.nlm.nih.gov]
  • A pleural effusion may cause you to cough or feel short of breath. You may breathe faster than usual. You may have mild to severe chest pain that starts or gets worse when you breathe in or cough.[drugs.com]
Dyspnea
  • CASE PRESENTATION: An 84-year-old Japanese non-smoking woman with a history of lung cancer, treated by surgery, was admitted due to gradual worsening of dyspnea that had occurred over the previous month.[ncbi.nlm.nih.gov]
  • CASE REPORT A 36-year-old Indian woman with a medical history of recurrent pleural effusions presented with chief complaints of dyspnea on exertion for one year and a low-grade fever for one month.[ncbi.nlm.nih.gov]
  • If dyspnea caused by malignant pleural effusion is relieved by thoracentesis but fluid and dyspnea redevelop, chronic (intermittent) drainage or pleurodesis is indicated.[merckmanuals.com]
  • Dyspnea, or shortness of breath, is common with emergency department patients.[appliedradiology.com]
  • CASE REPORT The patient was a 74-year-old nonsmoking female with a 3-month history of exertional dyspnea and back pain.[ncbi.nlm.nih.gov]
Orthopnea
  • The patient may have unrelated symptoms due to the disease or condition that has caused the effusion.Symptoms of pleural effusion include: Chest pain Dry, nonproductive cough Dyspnea (shortness of breath, or difficult, labored breathing) Orthopnea (the[my.clevelandclinic.org]
  • Signs: Pleural Effusion cause-specific examination Constitutional Fever ( Pneumonia , empyema, Tb, malignancy, abdominal abscess) Pulmonary Hemoptysis (malignancy, PE, Tb) Cardiovascular Increased Jugular Venous Pressure (CHF, Pericarditis ) Orthopnea[fpnotebook.com]
  • Signs: Pleural Effusion cause-specific examination Constitutional Fever ( Pneumonia, empyema, Tb, malignancy, abdominal abscess) Pulmonary Hemoptysis (malignancy, PE, Tb) Cardiovascular Increased Jugular Venous Pressure (CHF, Pericarditis ) Orthopnea[fpnotebook.com]
Decreased Breath Sounds
  • Patient was in mild distress and had decreased breath sounds over right lung fields about halfway up with dullness to percussion. Computed tomography of the chest showed a moderate-sized right pleural effusion and an anterior mediastinal mass.[ncbi.nlm.nih.gov]
  • Physical exam is notable for a woman with increased work of breathing and decreased breath sounds over the right lower lobe. A chest radiograph is performed, which demonstrates an extensive right pleural effusion.[step2.medbullets.com]
  • The physician will listen to the chest with a stethoscope for signs of decreased breath sounds or a pleural friction rub--the sound of pleura rubbing together during respiration. Duration: 01:44 Published: 15/02/2016[blausen.com]
  • breath sounds Decreased Vocal resonance Bronchial breathing or aegophony (bleating vocal resonance) over top of effusion, due to lung compression Differential diagnosis of pleural effusion (decreased air entry on auscultation) Consolidation Collapse[oxfordmedicaleducation.com]
  • Physical examination revealed dullness to percussion and decreased breath sounds throughout his right hemithorax, with normal lung sounds on the left.[rc.rcjournal.com]
Severe Abdominal Pain
  • Seven days after, she presented a progressive deterioration of its general condition and the onset of severe abdominal pain.[ncbi.nlm.nih.gov]
  • Acute pancreatitis is a common cause of severe abdominal pain. BananaStock/BananaStock/Getty Images Your pancreas is a long, teardrop-shaped organ located deep within your upper abdomen, just beneath your diaphragm and lungs.[livehealthy.chron.com]
Heart Failure
  • Although Light's criteria correctly identified all of the exudates, five patients with congestive heart failure were misclassified as exudates.[ncbi.nlm.nih.gov]
  • The Rational Clinical Examination Series review found that bilateral effusions, symmetric and asymmetric, are the most common distribution in heart failure (60% of effusions in heart failure will be bilateral).[en.wikipedia.org]
  • She had received treatment on lines of chronic liver disease, congestive heart failure but did not manifest any improvement. Laboratory investigations including haemogram, echocardiography and liver function testing were inconclusive.[ncbi.nlm.nih.gov]
  • The most common underlying cause is congestive heart failure. Other common causes include lung infections, some cancers, and blood clots in the lung.[sharecare.com]
  • In the general population, these illnesses include congestive heart failure, infection, and malignancy.[ncbi.nlm.nih.gov]
Kidney Failure
  • A pleural effusion can be caused by many different conditions, including: heart failure infections such as pneumonia kidney failure liver disease low blood protein levels blockage of a major blood vessel cancer chest injury Pleural effusion is different[healthdirect.gov.au]
  • Rare causes — Radiation therapy (for cancer), a collapsed lung (pneumothorax) and pericarditis (as with severe kidney failure or following a heart attack) all can be associated with pleurisy.[health.harvard.edu]
  • Examples of transudate pleural effusions include: Congestive heart failure Liver failure or cirrhosis Kidney failure or nephritic syndrome Peritoneal dialysis 2.[emedicinehealth.com]
  • In general, effusions may be caused by congestive heart failure, kidney failure, kidney disease, low albumin levels in the blood, infection, cancer, a pulmonary embolism, cirrhosis of the liver, an injury or trauma, pneumonia, or an autoimmune disease[study.com]
  • The following is a list of some of the major causes: Congestive heart failure Kidney failure Infection Malignancy Pulmonary embolism Hypoalbuminemia Cirrhosis Trauma The development of a pleural effusion occurs from fluid seeping into the pleural space[medicinenet.com]

Workup

  • Echocardiogram showed ejection fraction of 45% and cardiac workup for sarcoid involvement was negative.[ncbi.nlm.nih.gov]
  • It can save the clinician significant time and avoid unnecessary additional workup. Remember, however, that Light’s criteria is more sensitive than specific test for exudative effusions.[mdcalc.com]
  • If the etiology of the exudate is still unknown after the above workup, then a pleural biopsy is generally indicated. This procedure can be done through various methods, such as image-guided needle biopsy or thoracoscopic biopsy.[clinicaladvisor.com]
  • If FLDH rather than TPR had been used as the sole diagnostic test in our series of 200 patients, one fewer patient would have been subjected to further diagnostic workup.[doi.org]
Atelectasis
  • Arterial blood gases, pleural effusion, and atelectasis were compared between groups. Atelectasis and pleural effusion was reduced in experimental group.[ncbi.nlm.nih.gov]
  • Atelectasis – a collapsed or airless state of the lung – may be acute or chronic, and may involve all or part of the lung. The primary cause of atelectasis is obstruction of the bronchus serving the affected area.[cardiachealth.org]
  • Types of disorders that can cause transudative effusions include congestive heart failure, cirrhosis, and atelectasis. It is also associated with some medical procedures, such as peritoneal dialysis.[blausen.com]
  • This cannot be atelectasis from compression - it is pneumonia with an associated effusion. A massive effusion. The depth between the pleura is 6cm.[icmteaching.com]
  • Exudate – parapneumonic effusion, empyema, subphrenic abscess, pancreatitis Transudate – increased hydrostatic pressure (heart and liver failure, fluid overload), decreased oncotic pressure (nephrotic syndrome, loosing protein), negative pleural pressure (atelectasis[lifeinthefastlane.com]
Pleural Effusion on Chest X-Ray
  • The usual tests that will identify pleural effusions are: Chest X-ray film : Many times, the first step in diagnosing is plain X-ray films. They will show up on chest X-rays as a white space at the bottom of the lung.[md-health.com]
  • […] en I'll treat the effusion with a thorancentesis. en AND new infiltrate, consolidation or pleural effusion on chest X ray hr G. predsjedniče, g. potpredsjedniče en " Effusions of fancy by a very young girl in a style entirely new. " hr Mislim da nam je[hr.glosbe.com]
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]
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]
Paragonimus Westermani
  • The diagnosis was confirmed using enzyme-linked immunosorbent assays, which showed elevated Paragonimus westermani and Paragonimus miyazakii antibody levels. After the initiation of praziquantel therapy, all clinical findings were promptly improved.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Pleural effusion with MM was caused by congestive heart disease, chronic renal failure, hypoalbuminemia, pulmonary infarctions, cirrhosis, pulmonary arterial hypertension, parapneumonic effusion, tuberculous pleural effusion, and myelomatous pleural effusion[ncbi.nlm.nih.gov]
  • Although pleural effusion is a common complication of maintenance hemodialysis, few reports have documented the use of pleuroperitoneal shunt to control refractory pleural effusion.[ncbi.nlm.nih.gov]
  • Pleural disease Empyema Heart failure Pulmonary embolism Subpulmonic effusion Thoracentesis MedlinePlus Encyclopedia Pleural Effusion Pleural Effusion Images from MedPix[en.wikipedia.org]
  • effusion Loculated pleural effusion Pleural effusion Pleural effusion (fluid around lung) Secondary pleural effusion Clinical Information A disorder characterized by an increase in amounts of fluid within the pleural cavity.[icd9data.com]
  • The diagnostic yield of medical thoracoscopy for tuberculous pleural effusion was 91.4%. Malignant pleural effusions accounted for 5.2% of cases. Minor bleeding occurred in 1.2% of cases with no procedure-related mortality observed.[ncbi.nlm.nih.gov]

Treatment

  • Treatment outcomes were compared between patients with TPE with and without cancer.[ncbi.nlm.nih.gov]
  • Our patient responded promptly to oral corticosteroid treatment in a few days. The pulmonary infiltrates and pleural effusion subsided on a 1-month follow-up chest radiograph after starting corticosteroid treatment.[ncbi.nlm.nih.gov]
  • We report successful treatment of refractory pleural effusion using a Denver pleuroperitoneal shunt in one such patient.[ncbi.nlm.nih.gov]
  • The treatment was effective in our case. Abatacept should be considered as a treatment option in patients with refractory rheumatoid pleural effusion.[ncbi.nlm.nih.gov]
  • The patient recovered after 15 months of antituberculosis treatment. The patient exemplifies the difficulty of diagnosing BTB, particularly the low reliability of imaging modalities.[ncbi.nlm.nih.gov]

Prognosis

  • The three cases and literature review suggest that MPE is rare and often associated with a poor prognosis.[ncbi.nlm.nih.gov]
  • Squamous cancer (SqCC) of the lung has a poor prognosis. With the advent of immunotherapy, prognosis has tended to improve; however, pseudoprogression poses a challenge to the management of immunotherapy.[ncbi.nlm.nih.gov]
  • Such patients generally present late and have a poor prognosis. Here, we describe a patient presenting with a lung mass, renal failure and a massive unilateral pleural effusion due to multiple myeloma who was treated successfully.[ncbi.nlm.nih.gov]
  • Histopathology diagnosed this as a calcifying fibrous tumour of the pleura, a rare benign tumour with excellent prognosis when completely excised.[ncbi.nlm.nih.gov]
  • All patients with both 32 gestational weeks and CONCLUSIONS: Combined with the gestational weeks data, birthweight SD score may be useful to estimate the prognosis of HF with pleural effusion. 2017 Japan Pediatric Society.[ncbi.nlm.nih.gov]

Etiology

  • The aims of this study were to determine the diagnostic yield and safety of medical thoracoscopy for exudative pleural effusions and ascertain the etiology of such effusions in Qatar.[ncbi.nlm.nih.gov]
  • 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]
  • Biopsy showed noncaseating granulomas consistent with sarcoid, with all stains and microbiologic cultures negative for an infectious etiology.[ncbi.nlm.nih.gov]
  • In endemic countries Brucellosis must thought as an unknown etiology of pericardial and pleural effusion. 2016 John Wiley & Sons Ltd. KEYWORDS: brucellosis; childhood; pericardial effusion; pleural effusion[ncbi.nlm.nih.gov]
  • This case describes an HIV-infected man who was an active cigarette smoker and alcoholic and who presented with a large pleural effusion of uncertain etiology.[ncbi.nlm.nih.gov]

Epidemiology

  • Aged Pleural Effusion/drug therapy* Pleural Effusion/epidemiology Pleural Effusion/genetics Recurrence Retrospective Studies Treatment Outcome Young Adult Substance Dasatinib[ncbi.nlm.nih.gov]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
  • Definition of pleural effusion Accumulation of fluid between the pleural layers Epidemiology of pleural effusion Estimated prevalence of pleural effusion is 320 cases per 100,000 people in industrialized countries, with a distribution of etiologies related[oxfordmedicaleducation.com]
  • […] discussed separately: empyema (pyothorax) chylothorax hemothorax urinothorax infusothorax (chemothorax) As the accumulation of fluid in the pleural space occurs in a large and disparate clinical scenarios, no single demographic is affected; rather the epidemiology[radiopaedia.org]
  • […] separately: empyema (pyothorax) chylothorax hemothorax urinothorax (urothorax) infusothorax (chemothorax) As the accumulation of fluid in the pleural space occurs in a broad range of disparate clinical scenarios, no single demographic is affected; rather the epidemiology[radiopaedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Abstract The pathophysiology of isolated pleural effusion in ovarian hyperstimulation syndrome (OHSS) is not well defined.[ncbi.nlm.nih.gov]
  • Author information 1 Cytopathology Department, Laiko Hospital, Athens, Greece. 2 Immunology Department, Laiko Hospital, Athens, Greece. 3 Pathophysiology Department, Laiko Hospital, Medical School, University of Athens, Greece. 4 Histopathology Department[ncbi.nlm.nih.gov]
  • View Article PubMed Google Scholar Sahn SA: The pathophysiology of pleural effusions. Annu Rev Med. 1990, 41: 7-13. 10.1146/annurev.med.41.1.7.[doi.org]
  • Pathophysiology Fluid accumulation in pleural space lung lobes unable to expand dyspnea. True transudates associated with hypoproteinemia.[vetstream.com]
  • By the origin of the fluid: Serous fluid (hydrothorax) Blood (haemothorax) Chyle (chylothorax) Pus (pyothorax or empyema) Urine (urinothorax)By pathophysiology: Transudative pleural effusion Exudative pleural effusionBy the underlying cause (see next[en.wikipedia.org]

Prevention

  • The objective of the current review is to delineate the pathophysiology, risk factors, preventive measures, and therapeutic options of isolated pleural effusion in severe OHSS. Major databases were searched until June 2016.[ncbi.nlm.nih.gov]
  • […] type Status report message null description The server encountered an internal error that prevented it from fulfilling this request.[xa.yimg.com]
  • Surgery May Be Required When locutaion prevents fluid drainage, the standard of care is surgery to remove the scar tissue.[lungtx.com]
  • In such cases, regular close follow-up is important to minimize infections and to prevent development of cor pulmonale or respiratory failure.[ncbi.nlm.nih.gov]

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