PLEURAL EFFUSION

General Information

DEFINITION--An abnormal accumulation of fluid in the pleural space. Pleura are the thin membranes that line the lungs and chest cavity. Normally the fluid in this area provides lubrication and allows smooth, uniform contractions of the lungs during breathing. Types of pleural effusion include: empyema, characterized by an accumulation of pus due to infection, and hemothorax, the presence of blood in the pleural space.

BODY PARTS INVOLVED--Lung; pleura.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• No symptoms sometimes (with small effusions).
• Chest pain. Pain varies from vague discomfort to stabbing pain. It is often worse with coughing or breathing. Pain may extend to the lower chest wall or abdomen.
• Dry cough.
• Rapid, shallow breathing.
• Chills.
• Fever.
• Extreme fatigue.
• Bad breath.
• Weight loss.
• Night sweats.

CAUSES--

A complication of:

• Lung or chest infections, such as pneumonia, tuberculosis or lung abscess.
• Collapsed lung or chest injury.
• Malignancy in other parts of the body.
• Collagen vascular disease, such as systemic lupus erythematosus.
• Infection in another part of the body that has spread to the chest.
• Congestive heart failure.
• Kidney disorders.
• Liver disorders.

RISK INCREASES WITH

• Recent illness (see Causes).
• Smoking.
• Wet, cold climates.

HOW TO PREVENT--Obtain medical treatment for any serious disorder or infection that may lead to pleural effusion.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory culture of pleural fluid obtained by thoracentesis (needle inserted into the chest to withdraw fluid).
• X-ray and ultrasound (See Glossary) of the chest.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Treatment usually consists of surgery to open the infected cavity and drain any pus or blood, and sometimes insertion of tubes to allow further drainage.

POSSIBLE COMPLICATIONS

• Meningitis.
• Pericarditis.
• Endocarditis.
• Brain abscess.

PROBABLE OUTCOME--Successful treatment depends on discovery and treatment of the underlying disorder.

How To Treat

GENERAL MEASURES--

• Use an ultrasonic cool-mist humidifier to loosen bronchial secretions so they may be coughed up more easily. Clean humidifier daily.
• Practice these breathing exercises: Purse your lips and breathe forcefully against resistance (as if blowing out a candle) 10 times. Repeat every hour. Take 10 deep breaths every hour.
• Don't smoke.

MEDICATION--

• Your doctor may prescribe antibiotics to fight infection. The type of antibiotic will depend on the type of germ responsible and sensitivity studies (See Glossary).
• For minor pain, you may use non-prescription drugs such as acetaminophen.

ACTIVITY--Reduce activity until the pain and fever are gone. Gradually return to normal activity. Allow 2 months for recovery.

DIET--No special diet. Take vitamin supplements. Increase fluid intake.

Call Your Doctor If

• You have symptoms of empyema.
• The following occurs during treatment: Fever. Pain increases. Breathlessness worsens. Cough becomes dry and non-productive. Fingernails or toenails turn blue or dark. Blood appears in the sputum.