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When there is excessive collection of fluid between the pleural space (space between the thin membrane lining the lung and the chest wall) it is called pleural effusion.
It generally reflects the underlying pathology with variety of disorders of lungs, pleura and systemic disorders being the cause.
The outer surface of the lung and the chest wall are lined by pleural.
Space between them is called pleural space. It is in this space that the fluid is collected and called as effusion.
This happens due to transudative or exudative cause which lead to inflammation, irritated or infection of the pleura hence cause accumulation of the fluid.
Exudate cause secondary to damage to lung, inflammation, infection, tumors, and due to blockage of blood vessels or lymphatic system.
• Infection : bacterial, virus or TB
• Lung cancer
• Metastatic causes
• Pulmonary embolism
• Trauma (hemothorax)
• Autoimmune like Wegener’s Granulomatosis
• Asbestos related
• Hepatitis related
• Esophageal perforation
• Post Partum
• Post abdominal surgery
• Trapped lung
• Drug induced – Nitrofurantoin or Amiodarone
• Enteral feeding tube misplacement
• Connective tissue disorder
• Rheumatoid arthritis
Transudate cause when fluid leaks into pleural space due to increase pressure in the blood vessels with congestive heart failure being the most common cause.
• Congestive heart failure
• Nephrotic syndrome
• Peritoneal dialysis
• Chest pain (pleurisy) this is experienced while taking deep breaths.
• Dry cough
• Shortness of breath
• Difficulty in breathing on lying down or while carrying out certain activities
• Lung damage
• Empyema, its when the infection turns into a well organised collection.
• Air in the chest cavity (pneumothorax) which can be secondary from the procedural/ drainage of the fluid.
• Pleural thickening (scarring of the lining of the lung)
• Quit smoking: Quit cigarette smoking and avoid being a passive smoker as well.
• Wear a mask (N95 respirators) to avoid environmental stimuli like pollution or to asbestos particles at work.
• Vaccines: Getting annual flu vaccines to prevent influenza and virus and vaccine to prevent certain types of pneumonia.
• Quit alcohol: liver dysfunction is major cause of pleural effusion .
• Get cardiac work up/ screening done: all high risk patients should be screened at regular intervals.
• Radiograph of the chest- Chest X-ray shows us changes in lung parenchyma, associated complications ~ signs of pulmonary infections or heart failure.
• Treat the cause: fluid in the pleural space generally is a reflection of underlying pathology hence most important line of treatment is to treat the cause.
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