Pleural effusion and empyema Flashcards
what is a pleural effusion
abnormal collection of fluid in the pleural space
two types of pleural effusion
- transudate (low protein)
2. exudate (high protein)
causes of transudate pleural effusion
heart failure, constrictive pericarditis and hypoproteinaemia
causes of exudate pleural effusion
malignancy pneumonia TB post MI pancreatitis
presentation of a pleural effusion
- stony dull to percuss
- reduced expansion
diagnosis of pleural effusion
- PA CXR
- pleural aspirate
management of a pleural effusion
- diuretics e.g. furosemide
- antibiotics if infective
- chest drain if pH <7.2
where should the chest drain be placed?
‘safe’ triangle
- anterior border of the latissimus dorsi
- lateral border of pectoralis major
- above the level of the nipple
what does a straw-coloured effusion indicate?
cardiac failure
what does a bloody effusion indicate?
malignancy, trauma
what does a milky effusion indicate?
empyema or chylothorax (lymph from the digestive system)
what does a foul-smelling effusion indicate?
anaerobic empyema
what does the presence of food in the effusion indicate?
oesophageal rupture
what is an empyema
pus in the pleural space
presentation of an empyema
- fever
- malaise
- SOB, chest pain
- weight loss
