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What percent of people have parapneumonic pleural effusion?
Emthundiyi
30% - 50%.
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∙ 7y ago
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Pleural effusion?
DefinitionA pleural effusion is an accumulation of fluid between the layers of tissue that line the lungs and chest cavity.Alternative NamesFluid in the chest; Fluid on the lung; Pleural fluidCauses, incidence, and risk factorsYour body produces pleural fluid in small amounts to lubricate the surfaces of the pleura, the thin tissue that lines the chest cavity and surrounds the lungs. A pleural effusion is an abnormal, excessive collection of this fluid.Two different types of effusions can develop:Transudative pleural effusions are caused by fluid leaking into the pleural space. This is caused by elevated pressure in, or low protein content in, the blood vessels. Congestive heart failure is the most common cause.Exudative effusions usually result from leaky blood vessels caused by inflammation (irritation and swelling) of the pleura. This is often caused by lung disease. Examples include lung cancer, lung infections such as tuberculosis and pneumonia, drug reactions, and asbestosis.SymptomsChest pain, usually a sharp pain that is worse with cough or deep breathsCoughFeverHiccupsRapid breathingShortness of breathSometimes there are no symptoms.Signs and testsDuring a physical examination, the doctor will listen to the sound of your breathing with a stethoscope and may tap on your chest to listen for dullness.The following tests may help to confirm a diagnosis:Chest x-rayPleural fluid analysis (examining the fluid under a microscope to look for bacteria, amount of protein, and presence of cancerous cells)Thoracentesis(a sample of fluid is removed with a needle inserted between the ribs)Thoracic CTUltrasound of the chestTreatmentTreatment may be directed at removing the fluid, preventing it from accumulating again, or addressing the underlying cause of the fluid buildup.Therapeutic thoracentesis may be done if the fluid collection is large and causing pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Removing the fluid allows the lung to expand, making breathing easier. Treating the underlying cause of the effusion then becomes the goal.For example, pleural effusions caused by congestive heart failure are treated with diuretics (water pills) and other medications that treat heart failure. Pleural effusions caused by infection are treated with appropriate antibiotics. In people with cancer or infections, the effusion is often treated by using a chest tube for several days to drain the fluid. Chemotherapy, radiation therapy, surgery, or instilling medication into the chest that prevents re-accumulation of fluid after drainage may be used in some cases.Expectations (prognosis)The expected outcome depends upon the underlying disease.ComplicationsA lung surrounded by excess fluid for a long time may collapse.Pleural fluid that becomes infected may turn into an abscess, called an empyema, which requires prolonged drainage with a chest tube placed into the fluid.Pneumothorax(air within the chest cavity) can be a complication of the thoracentesis procedure.Calling your health care providerCall your health care provider if you have symptoms of pleural effusion.Call your provider or go to the emergency room if shortness of breath or difficulty breathing occurs immediately after thoracentesis.
Pleural fluid analysis?
DefinitionPleural fluid analysis examines fluid that has collected in the pleural space -- the small area outside of the lungs but inside the chest cavity.See also: Pleural effusionHow the test is performedA procedure called thoracentesis is used to get a sample of pleural fluid. The health care provider examines the sample to look for:Cancerous (malignant) cellsCellular makeupChemical contentTiny organisms that can cause disease (microorganisms)How to prepare for the testThe test is no more invasive than having blood drawn. There is no special preparation. Do not cough, breathe deeply, or move during the test to avoid injury to the lung.You may have a chest x-ray before or after the test. Tell your doctor if you take medicines to thin the blood.How the test will feelYou will sit on the edge of a chair or bed with your head and arms resting on a table. The health care provider will clean the skin around the insertion site and drape the area. A local pain-killing medicine (anesthetic) is injected into the skin, which stings a bit, but only for a few seconds.The thoracentesis needle is inserted above the rib into the pocket of fluid. As fluid drains into a collection bottle, many people cough a bit as the lung reexpands to fill the space where fluid had been. This sensation normally lasts for a few hours after the test is completed. Tell your health care provider if you have sharp chest pain or shortness of breath.Why the test is performedThe test is performed to determine the cause of a pleural effusion, and to relieve the shortness of breath that a large pleural effusion can cause.Normal ValuesNormally the pleural cavity contains less than 20 milliliters (4 teaspoons) of clear, yellowish (serous) fluid.Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.What abnormal results meanAbnormal results may indicate possible causes of pleural effusion, such as:Cancer (neoplasm)CirrhosisHeart failureInfectionIf the health care provider suspects an infection, a culture of the fluid is done to check for bacteria.The test may also be performed for hemothorax, a collection of blood in the pleura.What the risks areThe risks of thoracentesis are:Collapse of the lung (pneumothorax)Excessive loss of bloodFluid re-accumulationInfectionPulmonary edemaRespiratory distressSerious complications are uncommon.ReferencesBroaddus VC, Light RW. Pleural effusion. In: Mason RJ, Murray J, Broaddus VC, Nadel J, eds. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier;2005:chap 68.
Can arthritis affect breathing?
Yes it can affect your lungs. In fact, lt. The most common lung problems associated with rheumatoid arthritis include:Rheumatoid arthritis can cause inflammation of the lining of the lungs (pleurisy). and this can cause sharp pain while breathing.Fluid May accumulate around the lungs as a result of inflammation of the lining of the lungs. (pleural effusion). This accumulation can cause shortness of breath.
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Tuberculous pleural effusion?
DefinitionTuberculous (TB) pleural infusion is a buildup of fluid in the space between the lining of the lung and the lung tissue (pleural space) after a severe, usually long-term infection with tuberculosis.See also:Pleural effusionTuberculosisCauses, incidence, and risk factorsAs the number of patients with HIV and AIDS increases, this condition is occurring more often.Signs and testsFluid can be removed with a needle (thoracentesis) from the pleural space. However, in most cases, the tuberculosis bacteria cannot be found in the fluid by examining it under a microscope or by trying to grow the bacteria in the laboratory from a sample of pleural fluid (culture).The best way to make the diagnosis is to remove a piece of the lining of the lung (pleural tissue) by biopsy. This is more likely to reveal the disease-causing organism through a culture or by examining it under a microscope.Special dyes are added to a sample to see the bacteria under the microscope. The organism takes up the dye, and then appears colored when viewed under a microscope.TreatmentTreatment of tuberculous pleural effusion will always involve a combination of many drugs (usually four drugs). The medicines are continued until lab tests show which medicines work best.Medications that may be prescribed include:Isoniazid (INH)RifampinPyrazinamideAmikacinEthambutolEthionamideMoxifloxacinPara-aminosalicylic acid (PAS)StreptomycinYou must take the medicines every day by mouth for 1 year or longer. Directly observed therapy, in which a health care provider watches the patient take the prescribed antituberculous drugs, is the most effective strategy for some patients. In this case, drugs may be given 2 or 3 times per week, as prescribed by a doctor.You may need to be admitted to a hospital for 2 to 4 weeks to avoid spreading the disease to others until you are no longer contagious.Your doctor or nurse is required by law to report your TB illness to the local health department. Your health care team will be sure that you receive the best care for your TB.Expectations (prognosis)The outlook is excellent if tuberculous pleural effusion is diagnosed early and treatment is begun quickly.ComplicationsTuberculous pleural effusion can cause permanent lung damage if not treated early.Medicines used to treat TB may cause side effects, including liver problems and:Changes in visionOrange- or brown-colored tears and urineRashCalling your health care providerCall your health care provider if:You have been exposed to TBYou develop symptoms of TBYour symptoms continue despite treatmentNew symptoms developPreventionTB is a preventable disease, even in those who have been exposed to an infected person. Skin testing (PPD) for TB is used in high risk populations or in people who may have been exposed to TB, such as health care workers.A positive skin test in a person with no symptoms of TB is a sign of a previous exposure to TB. Discuss preventive therapy with your doctor. People who have been exposed to TB should be skin tested immediately and have a follow-up test at a later date (usually 12 weeks), if the first test is negative.Prompt treatment is extremely important in controlling the spread of TB from those who have active TB disease to those who have never been infected with TB.Some countries with a high rate of TB give people a BCG vaccination to prevent TB. However, the effectiveness of this vaccine is controversial and it is not routinely used in the United States.ReferencesIseman MD. Tuberculosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 345.
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