exsudative

Exsudative, more commonly written exudative in English, is a medical term used to describe processes or fluids that contain or produce exudate. Exudate is a protein- and cell-rich fluid that leaks from blood vessels through inflammatory or injured tissue. Exudates arise from increased vascular permeability driven by inflammatory mediators and are typically associated with infection, inflammation, malignancy, or tissue injury. They contrast with transudates, which result from imbalances in hydrostatic or oncotic pressures and have lower protein content and fewer cells.

In clinical practice the term is often applied to effusions or wound fluids. Exudative effusions occur in body cavities such as the pleural, pericardial, or peritoneal spaces and are characterized by higher protein and cellular content. For pleural effusions, diagnostic criteria known as Light’s criteria are commonly used: a pleural fluid to serum protein ratio greater than 0.5, a pleural fluid to serum LDH ratio greater than 0.6, or a pleural fluid LDH more than two-thirds the upper limit of normal serum LDH. These findings point toward an inflammatory, infectious, malignant, or other exudative process rather than a simple fluid imbalance.

Common causes of exudative effusions include pneumonia with pleuritis, tuberculosis, malignancy, pancreatitis, and autoimmune diseases. In addition to effusions, exudation can occur in tissues and wounds during acute inflammation, contributing to edema, fibrin deposition, and cellular infiltration.

Diagnosis relies on fluid analysis, culture or cytology when indicated, imaging studies, and correlation with clinical findings. Treatment focuses on addressing the underlying cause, with supportive measures such as drainage or anti-inflammatory and antimicrobial therapies as appropriate.