The fluid can impair the breathing by limiting the expansion of the lung during inspiration.

Symptoms

• Dyspnea- indicates large effusion
• Chest pain
• Lower extremity edema
• Orthopnea- Dyspnea on lying down
• Night sweats
• Fever
• Hemoptysis
• Weight loss
• Cough with or without sputum

 Types of fluids

• four fluids can accumulate in pleural space.
• Serous fluid (hydrothorax)
• Blood (hemothorax)
• Chyle (chylothorax)
• Pus (pyothorax or empyema)

Causes:

Transduative:

• Heart failure
• Liver cirrhosis
• Hypoalbuminemia
• Nephrotic syndrome
• Peritoneal dialysis
• Myxedema

 Exudative:

• Carcinoma
• Tuberculosis
• Pancreatitis
• Trauma
• Collagen vascular disease
• Pulmonary embolism
• Asbestos exposure

Diagnosis

• Complete blood count
• Chest X-ray
• Pleural fluid aspiration and examination
• CT thorax

Treatment

Whether transudates or exudates drain large pleural effusions by needle or tube aspiration methods if causing severe respiratory symptoms

• To treat the underlying cause
• Restriction of fat intake helps in chylous effusion
• Antibiotics in empyema
• Drug Mechlorethmine used to treat pleural effusion
• Surgical intervention required if effusions cannot be drained adequately
• To repeat chest x-ray after fluid aspiration

Pleural effusions due to cancer (malignant effusions) carry bad prognosis.

Pleurodesis or pleural sclerosis is used to recurrent malignant effusions.

Para pneumonic effusions should be treated promptly without sequels.