Aetiopathological evaluation of pleural effusions
Keywords:Fluid, Pleura, Pleural effusion, Pleural fluid
Background: Pleural Effusion (PE) is a sign of disease and not a diagnosis itself. Hence an attempt was made to find out the etiological diagnosis of pleural effusion in cases.
Methods: Single center, observational, cross sectional hospital-based study. Samples were collected by systematic random sampling method; study was conducted in GSL Medical College. Patients admitted with pleural effusion in medical wards and ICU were taken. The patients >14 years age, both genders were included. All patients were interviewed to obtain detailed history and examined thoroughly as per pre-determined protocol. Chest x-ray, chest ultrasonogram, PF analysis, routine general investigations were conducted for all the participants; and pleural cytology in certain cases. PF was aspirated send for various microbiological investigations such as gram stain, culture.
Results: Out of 104 study participants, 78 were men and 26 were women and peak incidence of pleural effusion is 41-50 years. In this study, 58% cases were found to be tuberculoid, 25% malignant, 6% pyogenic.
Conclusions: Tuberculosis was found to be commonest and more prevalent cause of pleural effusion. Every case of pleural effusion should be meticulously investigated in order to arrive a diagnosis, whether tuberculous or non-tuberculous to proceed for specific therapy.
Crofton and Doughlas. Respiratory diseases. Anthoni Seaton, Doughlas Seaton, AGordonleitch. 5th ed. New York: McGraw-Hill; 2012:285-296.
Williams PL, Dyson M. 37th edition. Grays Anatomy. Lippincort; 2017:1267-1271.
Mayo PH, Doelken P. Pleural ultrasonography. Clin Chest Med. 2006;27(2):215-27.
Shorr RM, Crittenden M, Indeck M, Hartunian SL, Rodriguez A. Blunt thoracic trauma. Analysis of 515 patients. Annal Surg. 1987;206(2):200.
DeBiasi EM, Pisani MA, Murphy TE, Araujo K, Kookoolis A, Argento AC, et al. Mortality among patients with pleural effusion undergoing thoracentesis. European Respirat J. 2015;46(2):495-502.
Ferrer A, Osset J, Alegre J, Surinach JM, Crespo E, De Sevilla TF, et al. Prospective clinical and microbiological study of pleural effusions. Euro J Clin Microbiol Infect Dis. 1999;18(4):237-41.
Boddington M. Serous effusions in Coleman DV. Clinical Cyto Technol. 1989;3:271-5.
Berger HW, Mejia E. Tuberculous pleurisy. Chest. 1973 Jan 1;63(1):88-92.
Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA. 2012;307(22):2383-9.
Light RW, MacGregor MI, Ball Jr WC, Luchsinger PC. Diagnostic significance of pleural fluid pH and PCO2. Chest. 1973;64(5):591-6.