Author(s): Ramakrishna R1, Venkata Kalyan Kumar P2

We have studied 200 patients of pleural fluid presenting to our tertiary care centre. Presence of cases of pleural fluid is a
common presentation both in pulmonary and extrapulmonary diseases. We analysed the patients having both exudates and
transudates and studied the results.
We selected patients above 20 years of age and classified the patients with pleural fluid as having transudates and exudates.
We studied the causes of transudates and exudates. A total of 200 patients are studied in this prospective study. Diagnosis of
pleural exudates is made on the basis of Light’s criteria, chest x-ray, pleural fluid analysis, CT scan in selected patients, sputum
examination, bronchoscopy and bronchial washings. Moribund and non-cooperative patients and HIV positives were excluded
from the study.
Among the 200 patients, 91% have exudates. 9% have transudates by Light’s criteria. Tuberculosis is the commonest cause
of effusions (64.83%) followed by malignancy (13.73%) and sympneumonic or parapneumonic effusions (9.89%). Pleural
effusions occurred predominantly in males. Prevalence of diabetes Mellitus among cases of tuberculous pleural effusions is
13.56%. Tuberculous effusions are predominantly right-sided.
Predominant cases of pleural fluid are exudates. Commonest cause of pleural effusion is Tuberculosis followed by malignancy
both pulmonary and extrapulmonary and sym. and parapneumonic effusions. Prevalence of Diabetes among Tuberculous
pleural effusion cases is more or less same as in general population. Cough, expectoration fever, chest pain and breathlessness
are the common symptoms occurring in three fourths of the patients of tuberculous pleural effusion. Most of the cases of
Tuberculous effusion are above 30 years of age. In the diagnosis of tuberculous pleural effusion, Pleural fluid ADA is very
important. Pleural fluid cytology, pleural biopsy, bronchoscopy, bronchial washings and sputum examination can aid in
diagnosis of aetiology. Lung cancer is the commonest cause of malignant pleural effusions. Other causes of pleural effusion
though rare should be considered in selective patients.

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