Pleural Effusion

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Questions to Ask Your Pulmonary Care Team
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Signs and Symptoms

The most common symptoms of pleural effusion are shortness of breath and chest pain caused by compression of the lungs. Cough also can occur and there may be fever with empyema.

Causes

Common causes of pleural effusion are cardiac failure, tuberculosis, pulmonary embolism (blocked pulmonary artery), metastatic disease (cancer that has spread to the pleurae), lymphoma (cancer in lymphoid tissue), and trauma. Less common causes are liver and kidney disease, viral and fungal infection, mesothelioma (benign or malignant tumor originating in the mesothelial cells; malignancy is associated with exposure to asbestos), and adverse drug reaction. Pleural effusion also can occur as a complication after heart surgery.

Hemothorax (pleural effusion with blood in the accumulating fluid) is caused by trauma. Chylothorax, pleural effusion with chyle (lymph and fat) in the accumulating fluid, is caused by neoplastic disease (cancer) and by trauma that impairs the lymphatic draining system.

Some medications may produce drug-induced lupus. This is a chronic inflammatory syndrome that can manifest as pleurisy, pleural effusion, and other conditions. The syndrome usually goes away after the drug that causes the problem is withdrawn. These drugs include procainimide (antiarrythmia agent), hydralazine (antihypertensive agent), isoniazid (antibiotic), penicillamine (rheumatoid arthritis treatment), and the sulfonamides (antibiotic agents).

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