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==Overview== | ==Overview== | ||
In the United States, up to one million patients develop [[parapneumonic effusion]]s annually, and approximately 100,000 patients undergo [[pleurodesis]] for recurrent pleural effusions per year.<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. | authorlink = | editor =| others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins | location = Hagerstwon, MD | year = 2007 |origyear = |pages = | quote = | isbn = 0-7817-6957-4 | oclc = |doi = |url = | accessdate = }}</ref> Pleural effusion is reported to have an incidence of 0.32% in a study among the general population in central Bohemia. [[Congestive heart failure]] accounts for nearly 50% of cases, with malignancy, [[pneumonia]] and [[pulmonary emboli]] as the next three leading causes.<ref name="pmid8222812">{{cite journal | author = Marel M, Zrůstová M, Stasný B, Light RW | title = The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia | journal = Chest | volume = 104 | issue = 5 | pages = 1486–9 | year = 1993 | month = November | pmid = 8222812 | doi = | url = | issn = }}</ref> However, the distribution of causes is largely dependent on the population being studied. For example | In the United States, up to one million patients develop [[parapneumonic effusion]]s annually, and approximately 100,000 patients undergo [[pleurodesis]] for recurrent pleural effusions per year.<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. | authorlink = | editor =| others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins | location = Hagerstwon, MD | year = 2007 |origyear = |pages = | quote = | isbn = 0-7817-6957-4 | oclc = |doi = |url = | accessdate = }}</ref> Pleural effusion is reported to have an incidence of 0.32% in a study among the general population in central Bohemia. [[Congestive heart failure]] accounts for nearly 50% of cases, with malignancy, [[pneumonia]] and [[pulmonary emboli]] as the next three leading causes.<ref name="pmid8222812">{{cite journal | author = Marel M, Zrůstová M, Stasný B, Light RW | title = The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia | journal = Chest | volume = 104 | issue = 5 | pages = 1486–9 | year = 1993 | month = November | pmid = 8222812 | doi = | url = | issn = }}</ref> However, the distribution of causes is largely dependent on the population being studied. For example, the incidence of pleural effusion among [[ICU]] patients is estimated to be 22.19 ± 17%,<ref name="pmid11689765">{{cite journal| author=Azoulay E, Fartoukh M, Similowski T, Galliot R, Soufir L, Le Gall JR et al.| title=Routine exploratory thoracentesis in ICU patients with pleural effusions: results of a French questionnaire study. | journal=J Crit Care | year= 2001 | volume= 16 | issue= 3 | pages= 98-101 | pmid=11689765 | doi=10.1053/jcrc.2001.28784 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11689765 }} </ref> whereas the prevalence of tuberculous pleural effusion remains steady with respect to the total number of [[TB]] cases (14.3%-19.3%).<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> The incidence of [[parapneumonic effusions]] is constantly increasing, although, the microbial epidemiology of these effusions differs from [[pneumonia]] with a higher prevalence of [[anaerobic bacteria]].<ref name="pmid25595878">{{cite journal| author=Letheulle J, Kerjouan M, Bénézit F, De Latour B, Tattevin P, Piau C et al.| title=[Parapneumonic pleural effusions: Epidemiology, diagnosis, classification and management]. | journal=Rev Mal Respir | year= 2015 | volume= 32 | issue= 4 | pages= 344-57 | pmid=25595878 | doi=10.1016/j.rmr.2014.12.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25595878 }} </ref> The incidence of pediatric [[empyema]] increased from 1 per 100,000 children aged 0 to 14 years in 1998 to 10 per 100,000 in 2012, with a peak incidence of 13 per 100,000 in 2009<ref name="pmid27059295">{{cite journal| author=Mahon C, Walker W, Drage A, Best E| title=Incidence, aetiology and outcome of pleural empyema and parapneumonic effusion from 1998 to 2012 in a population of New Zealand children. | journal=J Paediatr Child Health | year= 2016 | volume= 52 | issue= 6 | pages= 662-8 | pmid=27059295 | doi=10.1111/jpc.13172 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27059295 }} </ref> with [[Staphylococcus aureus|''Staphylococcus aureus'']] as the most frequent cause followed by [[S. pneumoniae|''S. pneumoniae'']]. The age predominace of pleural effusion varies depending on the underlying cause. Greater than 60% of tuberculous pleural effusion commonly affects individuals between 15-44 years.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> Pleural effusions are the most common thoracic involvement findings in patients with [[POEMS syndrome]], affecting more than 40% of cases with median age at the time of diagnosis of [[POEMS syndrome]] as 45.1 years.<ref name="pmid24519469">{{cite journal| author=Cui RT, Yu SY, Huang XS, Zhang JT, Tian CL, Dou LP et al.| title=Incidence and risk factors of pleural effusions in patients with POEMS syndrome. | journal=Hematol Oncol | year= 2015 | volume= 33 | issue= 2 | pages= 80-4 | pmid=24519469 | doi=10.1002/hon.2135 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24519469 }} </ref> [[HIV]] infection,<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> pleural [[empyema]], and complicated [[parapneumonic effusion]] is mostly seen in middle-aged patients (53 ± 17 years).<ref name="pmid20440084">{{cite journal| author=Zablockis R, Petruskeviciene R, Nargela RV| title=[Causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion]. | journal=Medicina (Kaunas) | year= 2010 | volume= 46 | issue= 2 | pages= 113-9 | pmid=20440084 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20440084 }} </ref> Males are more commonly affected with tuberculous pleural effusion than females. The male to female ratio is approximately 3:2.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> Males are more commonly affected with pleural empyema and complicated parapneumonic pleural effusion than females. The male to female ratio is approximately 2:1.<ref name="pmid20440084">{{cite journal| author=Zablockis R, Petruskeviciene R, Nargela RV| title=[Causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion]. | journal=Medicina (Kaunas) | year= 2010 | volume= 46 | issue= 2 | pages= 113-9 | pmid=20440084 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20440084 }} </ref> There is no racial predilection to pleural effusion. Development of tuberculous pleural effusion is common on endemic developing countries with [[TB]] infection.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | ||
whereas the prevalence of tuberculous pleural effusion remains steady with respect to the total number of [[TB]] cases (14.3%-19.3%).<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> The incidence of [[parapneumonic effusions]] is constantly increasing although | |||
Pleural effusions are the most common thoracic involvement findings in patients with [[POEMS syndrome]], affecting more than 40% of cases with median age at the time of diagnosis of [[POEMS syndrome]] as 45.1 years.<ref name="pmid24519469">{{cite journal| author=Cui RT, Yu SY, Huang XS, Zhang JT, Tian CL, Dou LP et al.| title=Incidence and risk factors of pleural effusions in patients with POEMS syndrome. | journal=Hematol Oncol | year= 2015 | volume= 33 | issue= 2 | pages= 80-4 | pmid=24519469 | doi=10.1002/hon.2135 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24519469 }} </ref> [[HIV]] infection<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Incidence and | ===Incidence and Prevalence=== | ||
*In the United States, up to one million patients develop [[parapneumonic effusion]]s annually, and approximately 100,000 patients undergo [[pleurodesis]] for recurrent pleural effusions per year.<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. | authorlink = | editor =| others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins | location = Hagerstwon, MD | year = 2007 |origyear = |pages = | quote = | isbn = 0-7817-6957-4 | oclc = |doi = |url = | accessdate = }}</ref> Pleural effusion is reported to have an incidence of 0.32% in a study among the general population in central Bohemia. [[Congestive heart failure]] accounts for nearly 50% of cases, with malignancy, [[pneumonia]] and [[pulmonary emboli]] as the next three leading causes.<ref name="pmid8222812">{{cite journal | author = Marel M, Zrůstová M, Stasný B, Light RW | title = The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia | journal = Chest | volume = 104 | issue = 5 | pages = 1486–9 | year = 1993 | month = November | pmid = 8222812 | doi = | url = | issn = }}</ref> However, the distribution of causes is largely dependent on the population studied. | *In the United States, up to one million patients develop [[parapneumonic effusion]]s annually, and approximately 100,000 patients undergo [[pleurodesis]] for recurrent pleural effusions per year.<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. | authorlink = | editor =| others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins | location = Hagerstwon, MD | year = 2007 |origyear = |pages = | quote = | isbn = 0-7817-6957-4 | oclc = |doi = |url = | accessdate = }}</ref> Pleural effusion is reported to have an incidence of 0.32% in a study among the general population in central Bohemia. [[Congestive heart failure]] accounts for nearly 50% of cases, with malignancy, [[pneumonia]] and [[pulmonary emboli]] as the next three leading causes.<ref name="pmid8222812">{{cite journal | author = Marel M, Zrůstová M, Stasný B, Light RW | title = The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia | journal = Chest | volume = 104 | issue = 5 | pages = 1486–9 | year = 1993 | month = November | pmid = 8222812 | doi = | url = | issn = }}</ref> However, the distribution of causes is largely dependent on the population studied. | ||
*The incidence of pleural effusion among [[ICU]] patients is estimated to be 22.19 | *The incidence of pleural effusion among [[ICU]] patients is estimated to be 22.19 ± 17%.<ref name="pmid11689765">{{cite journal| author=Azoulay E, Fartoukh M, Similowski T, Galliot R, Soufir L, Le Gall JR et al.| title=Routine exploratory thoracentesis in ICU patients with pleural effusions: results of a French questionnaire study. | journal=J Crit Care | year= 2001 | volume= 16 | issue= 3 | pages= 98-101 | pmid=11689765 | doi=10.1053/jcrc.2001.28784 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11689765 }} </ref> | ||
*[[Tuberculosis]] is one of the most frequent causes of [[pleural effusion]]. Although the [[incidence]] has steadily declined in some countries (4.8 cases/100,000 population), the prevalence of tuberculous pleural effusion remains steady with respect to the total number of [[TB]] cases (14.3%-19.3%).<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | *[[Tuberculosis]] is one of the most frequent causes of [[pleural effusion]]. Although, the [[incidence]] has steadily declined in some countries (4.8 cases/100,000 population), the prevalence of tuberculous pleural effusion remains steady with respect to the total number of [[TB]] cases (14.3%-19.3%).<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | ||
*The incidence of [[parapneumonic effusions]] is constantly increasing although | *The incidence of [[parapneumonic effusions]] is constantly increasing, although, the microbial epidemiology of these effusions differs from [[pneumonia]] with a higher prevalence of [[anaerobic bacteria]].<ref name="pmid25595878">{{cite journal| author=Letheulle J, Kerjouan M, Bénézit F, De Latour B, Tattevin P, Piau C et al.| title=[Parapneumonic pleural effusions: Epidemiology, diagnosis, classification and management]. | journal=Rev Mal Respir | year= 2015 | volume= 32 | issue= 4 | pages= 344-57 | pmid=25595878 | doi=10.1016/j.rmr.2014.12.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25595878 }} </ref> | ||
*The incidence of pediatric [[empyema]] increased from 1 per 100 000 children aged 0 to 14 years in 1998 to 10 per 100 000 in 2012, with a peak incidence of 13 per 100 000 in 2009<ref name="pmid27059295">{{cite journal| author=Mahon C, Walker W, Drage A, Best E| title=Incidence, aetiology and outcome of pleural empyema and parapneumonic effusion from 1998 to 2012 in a population of New Zealand children. | journal=J Paediatr Child Health | year= 2016 | volume= 52 | issue= 6 | pages= 662-8 | pmid=27059295 | doi=10.1111/jpc.13172 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27059295 }} </ref> with [[Staphylococcus aureus]] as most frequent cause followed by [[S. pneumoniae]]. | *The incidence of pediatric [[empyema]] increased from 1 per 100,000 children aged 0 to 14 years in 1998 to 10 per 100,000 in 2012, with a peak incidence of 13 per 100,000 in 2009<ref name="pmid27059295">{{cite journal| author=Mahon C, Walker W, Drage A, Best E| title=Incidence, aetiology and outcome of pleural empyema and parapneumonic effusion from 1998 to 2012 in a population of New Zealand children. | journal=J Paediatr Child Health | year= 2016 | volume= 52 | issue= 6 | pages= 662-8 | pmid=27059295 | doi=10.1111/jpc.13172 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27059295 }} </ref> with [[Staphylococcus aureus|''Staphylococcus aureus'']] as the most frequent cause followed by [[S. pneumoniae|''S. pneumoniae'']]. | ||
===Age=== | ===Age=== | ||
The age predominace of pleural effusion varies depending on the underlying cause as | The age predominace of pleural effusion varies depending on the underlying cause as shown below: | ||
*Greater than 60% of tuberculous pleural effusion commonly affects individuals between 15-44 years.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | *Greater than 60% of tuberculous pleural effusion commonly affects individuals between 15-44 years.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | ||
| Line 29: | Line 27: | ||
*[[HIV]] infection<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | *[[HIV]] infection<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | ||
*Pleural [[empyema]] and complicated [[parapneumonic effusion]] is mostly seen in middle-aged patients (53 | *Pleural [[empyema]] and complicated [[parapneumonic effusion]] is mostly seen in middle-aged patients (53 ± 17 years).<ref name="pmid20440084">{{cite journal| author=Zablockis R, Petruskeviciene R, Nargela RV| title=[Causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion]. | journal=Medicina (Kaunas) | year= 2010 | volume= 46 | issue= 2 | pages= 113-9 | pmid=20440084 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20440084 }} </ref> | ||
===Gender=== | ===Gender=== | ||
* Males are more commonly affected with tuberculous pleural effusion than females. The male to female ratio is approximately 3:2.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | |||
Males are more commonly affected with tuberculous pleural effusion than | * Males are more commonly affected with pleural empyema and complicated parapneumonic pleural effusion than females. The male to female ratio is approximately 2:1<ref name="pmid20440084">{{cite journal| author=Zablockis R, Petruskeviciene R, Nargela RV| title=[Causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion]. | journal=Medicina (Kaunas) | year= 2010 | volume= 46 | issue= 2 | pages= 113-9 | pmid=20440084 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20440084 }} </ref> | ||
Males are more commonly affected with pleural empyema and complicated parapneumonic pleural effusion than | |||
===Race=== | ===Race=== | ||
There is no racial predilection to pleural effusion. | * There is no racial predilection to pleural effusion. | ||
===Developed/developing countries=== | ===Developed/developing countries=== | ||
* Development of tuberculous pleural effusion is common on endemic developing countries with [[TB]] infection.<ref name="pmid24721286">{{cite journal| author=Ferreiro L, San José E, Valdés L| title=Tuberculous pleural effusion. | journal=Arch Bronconeumol | year= 2014 | volume= 50 | issue= 10 | pages= 435-43 | pmid=24721286 | doi=10.1016/j.arbres.2013.07.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721286 }} </ref> | |||
==References== | ==References== | ||
Revision as of 17:15, 6 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
In the United States, up to one million patients develop parapneumonic effusions annually, and approximately 100,000 patients undergo pleurodesis for recurrent pleural effusions per year.[1] Pleural effusion is reported to have an incidence of 0.32% in a study among the general population in central Bohemia. Congestive heart failure accounts for nearly 50% of cases, with malignancy, pneumonia and pulmonary emboli as the next three leading causes.[2] However, the distribution of causes is largely dependent on the population being studied. For example, the incidence of pleural effusion among ICU patients is estimated to be 22.19 ± 17%,[3] whereas the prevalence of tuberculous pleural effusion remains steady with respect to the total number of TB cases (14.3%-19.3%).[4] The incidence of parapneumonic effusions is constantly increasing, although, the microbial epidemiology of these effusions differs from pneumonia with a higher prevalence of anaerobic bacteria.[5] The incidence of pediatric empyema increased from 1 per 100,000 children aged 0 to 14 years in 1998 to 10 per 100,000 in 2012, with a peak incidence of 13 per 100,000 in 2009[6] with Staphylococcus aureus as the most frequent cause followed by S. pneumoniae. The age predominace of pleural effusion varies depending on the underlying cause. Greater than 60% of tuberculous pleural effusion commonly affects individuals between 15-44 years.[4] Pleural effusions are the most common thoracic involvement findings in patients with POEMS syndrome, affecting more than 40% of cases with median age at the time of diagnosis of POEMS syndrome as 45.1 years.[7] HIV infection,[4] pleural empyema, and complicated parapneumonic effusion is mostly seen in middle-aged patients (53 ± 17 years).[8] Males are more commonly affected with tuberculous pleural effusion than females. The male to female ratio is approximately 3:2.[4] Males are more commonly affected with pleural empyema and complicated parapneumonic pleural effusion than females. The male to female ratio is approximately 2:1.[8] There is no racial predilection to pleural effusion. Development of tuberculous pleural effusion is common on endemic developing countries with TB infection.[4]
Epidemiology and Demographics
Incidence and Prevalence
- In the United States, up to one million patients develop parapneumonic effusions annually, and approximately 100,000 patients undergo pleurodesis for recurrent pleural effusions per year.[1] Pleural effusion is reported to have an incidence of 0.32% in a study among the general population in central Bohemia. Congestive heart failure accounts for nearly 50% of cases, with malignancy, pneumonia and pulmonary emboli as the next three leading causes.[2] However, the distribution of causes is largely dependent on the population studied.
- Tuberculosis is one of the most frequent causes of pleural effusion. Although, the incidence has steadily declined in some countries (4.8 cases/100,000 population), the prevalence of tuberculous pleural effusion remains steady with respect to the total number of TB cases (14.3%-19.3%).[4]
- The incidence of parapneumonic effusions is constantly increasing, although, the microbial epidemiology of these effusions differs from pneumonia with a higher prevalence of anaerobic bacteria.[5]
- The incidence of pediatric empyema increased from 1 per 100,000 children aged 0 to 14 years in 1998 to 10 per 100,000 in 2012, with a peak incidence of 13 per 100,000 in 2009[6] with Staphylococcus aureus as the most frequent cause followed by S. pneumoniae.
Age
The age predominace of pleural effusion varies depending on the underlying cause as shown below:
- Greater than 60% of tuberculous pleural effusion commonly affects individuals between 15-44 years.[4]
- Pleural effusions are the most common thoracic involvement findings in patients with POEMS syndrome, affecting more than 40% of cases with median age at the time of diagnosis of POEMS syndrome as 45.1 years.[7]
- Pleural empyema and complicated parapneumonic effusion is mostly seen in middle-aged patients (53 ± 17 years).[8]
Gender
- Males are more commonly affected with tuberculous pleural effusion than females. The male to female ratio is approximately 3:2.[4]
- Males are more commonly affected with pleural empyema and complicated parapneumonic pleural effusion than females. The male to female ratio is approximately 2:1[8]
Race
- There is no racial predilection to pleural effusion.
Developed/developing countries
- Development of tuberculous pleural effusion is common on endemic developing countries with TB infection.[4]
References
- ↑ 1.0 1.1 Light, Richard J. (2007). Pleural diseases. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-6957-4.
- ↑ 2.0 2.1 Marel M, Zrůstová M, Stasný B, Light RW (1993). "The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia". Chest. 104 (5): 1486–9. PMID 8222812. Unknown parameter
|month=ignored (help) - ↑ 3.0 3.1 Azoulay E, Fartoukh M, Similowski T, Galliot R, Soufir L, Le Gall JR; et al. (2001). "Routine exploratory thoracentesis in ICU patients with pleural effusions: results of a French questionnaire study". J Crit Care. 16 (3): 98–101. doi:10.1053/jcrc.2001.28784. PMID 11689765.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Ferreiro L, San José E, Valdés L (2014). "Tuberculous pleural effusion". Arch Bronconeumol. 50 (10): 435–43. doi:10.1016/j.arbres.2013.07.006. PMID 24721286.
- ↑ 5.0 5.1 Letheulle J, Kerjouan M, Bénézit F, De Latour B, Tattevin P, Piau C; et al. (2015). "[Parapneumonic pleural effusions: Epidemiology, diagnosis, classification and management]". Rev Mal Respir. 32 (4): 344–57. doi:10.1016/j.rmr.2014.12.001. PMID 25595878.
- ↑ 6.0 6.1 Mahon C, Walker W, Drage A, Best E (2016). "Incidence, aetiology and outcome of pleural empyema and parapneumonic effusion from 1998 to 2012 in a population of New Zealand children". J Paediatr Child Health. 52 (6): 662–8. doi:10.1111/jpc.13172. PMID 27059295.
- ↑ 7.0 7.1 Cui RT, Yu SY, Huang XS, Zhang JT, Tian CL, Dou LP; et al. (2015). "Incidence and risk factors of pleural effusions in patients with POEMS syndrome". Hematol Oncol. 33 (2): 80–4. doi:10.1002/hon.2135. PMID 24519469.
- ↑ 8.0 8.1 8.2 8.3 Zablockis R, Petruskeviciene R, Nargela RV (2010). "[Causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion]". Medicina (Kaunas). 46 (2): 113–9. PMID 20440084.