Pleural effusion differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
mNo edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Pleural effusion}}
{{Pleural effusion}}
{{CMG}}
{{CMG}} {{AE}}


==Overview==
==Overview==
Line 47: Line 47:
{{Reflist|2}}
{{Reflist|2}}


[[Category:Disease]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Primary care]]
[[Category:Needs content]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Revision as of 16:17, 6 June 2016

Pleural effusion Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pleural Effusion from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Echocardiography and Ultrasound

CT Scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Pleural effusion differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pleural effusion differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pleural effusion differential diagnosis

CDC on Pleural effusion differential diagnosis

Pleural effusion differential diagnosis in the news

Blogs on Pleural effusion differential diagnosis

Directions to Hospitals Treating Pleural effusion

Risk calculators and risk factors for Pleural effusion differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview

Evaluation of a patient with a pleural effusion requires a thorough clinical history and physical examination in conjunction with pertinent laboratory tests and imaging studies. Thoracentesis should not be performed for bilateral effusions in a clinical setting strongly suggestive of a transudate unless there are atypical features or they fail to respond to therapy. Pleural fluid should always be sent for protein, lactate dehydrogenase, Gram stain, cytology and microbiological culture.[1] Additional studies which may be indicated in selected cases include pH, glucose, acid-fast bacilli and tuberculosis culture, triglyceride, cholesterol, amylase, and hematocrit. Light's criteria is applied to distinguish the fluid between transudative or exudative.[2] A broad array of underlying conditions result in exudative effusions, while a limited number of disorders are assoicated with transudative effusions, which include congestive heart failure, cirrhosis, nephrotic syndrome, peritoneal dialysis, hypoalbuminemia, urinothorax, atelectasis, constrictive pericarditis, trapped lung, superior vena caval obstruction, and duropleural fistula.

Differentiating Pleural Effusion from other Diseases

Exudative Pleural Effusions

Etiology Underlying conditions
Infectious Bacterial pneumonia, tuberculous effusion, fungal disease, atypical pneumonias, nocardia, actinomyces, subphrenic abscess, hepatic abscess, splenic abscess, hepatitis, parasites
Iatrogenic Drug-induced, esophageal perforation, esophageal sclerotherapy, central venous catheter misplacement or migration, enteral feeding tube in pleural space
Vasculitis Wegener granulomatosis, Churg–Strauss syndrome, familial Mediterranean fever
Malignancy Carcinoma, lymphoma, mesothelioma, leukemia, chylothorax
Inflammatory Pancreatitis, benign asbestos pleural effusion (BAPE), pulmonary infarction, radiation therapy, sarcoidosis, post-cardiac injury syndrome (PCIS), hemothorax, acute respiratory distress syndrome (ARDS), cholesterol effusion
Increased negative intrapleural pressure Atelectasis, trapped lung
Connective tissue disease Lupus pleuritis, rheumatoid pleurisy, mixed connective tissue disease, Sjögren syndrome
Endocrine dysfunction Hypothyroidism, ovarian hyperstimulation syndrome
Lymphatic abnormalities Chylothorax, yellow nail syndrome, lymphangiomyomatosis, lymphangiectasis
Movement of fluid from abdomen to pleural space Acute pancreatitis, pancreatic pseudocyst, Meigs syndrome, chylous ascites

References

  1. Hooper C, Lee YC, Maskell N (2010). "Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010". Thorax. 65 Suppl 2: ii4–17. doi:10.1136/thx.2010.136978. PMID 20696692. Unknown parameter |month= ignored (help)
  2. Light RW, Macgregor MI, Luchsinger PC, Ball WC (1972). "Pleural effusions: the diagnostic separation of transudates and exudates". Ann. Intern. Med. 77 (4): 507–13. PMID 4642731. Unknown parameter |month= ignored (help)

Template:WH Template:WS