pleuraefuusioon

Pleuraefuusioon is a medical term referring to the abnormal accumulation of fluid in the pleural cavity, the space between the lungs and the chest wall. This condition arises when the balance between fluid production and drainage in the pleural space is disrupted, often reflecting an underlying disease process.

Most pleuraefuusioons are classified as transudates or exudates. Transudates result from systemic factors such as congestive heart failure, cirrhosis with ascites, or nephrotic syndrome, leading to fluid leakage without local inflammation. Exudates arise from local pleural disease, including infections (for example pneumonia, tuberculosis), malignancy, inflammatory conditions, or pulmonary embolism. Special forms include chylothorax, hemothorax, and purulent effusions (empyema).

Clinical presentation typically includes shortness of breath and, in some cases, pleuritic chest pain. On examination, there may be reduced breath sounds, dullness to percussion, and decreased tactile fremitus over the affected area. The degree of symptoms often correlates with the size of the effusion.

Diagnosis relies on imaging and pleural fluid analysis. Chest radiography or ultrasound detects and localizes effusions; ultrasound-guided thoracentesis is commonly used to obtain fluid. Pleural fluid is analyzed for protein, LDH, cell count, pH, glucose, and microbiology. Light’s criteria help distinguish transudates from exudates. Cytology is used when malignancy is suspected, and culture or PCR can identify infectious etiologies. In some cases, CT imaging provides further localization.

Management targets the underlying cause and symptomatic relief. Small effusions may be managed expectantly; larger effusions are drained by thoracentesis or chest tube. Recurrent or malignant effusions may require pleurodesis or an indwelling pleural catheter. Prognosis depends on the underlying disease and response to treatment.