A STUDY OF CLINICAL PROFILE, AETIOLOGY AND OUTCOME OF PATIENTS PRESENTING WITH PLEURAL EFFUSION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 8
Abstract
BACKGROUND Pleural effusion is excess fluid that accumulates in the pleural space which is always abnormal and indicates the presence of an underlying disease. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during respiration. Our study is an etiological study of pleural effusion by conventional methods, such as clinical presentation along with radiological, biochemical and cytological correlation in J.J.M. Medical College attached Hospitals. The purpose of article is to study the etiological profile, clinical profile and outcome of patients admitted with pleural effusion. MATERIALS AND METHODS This was a prospective observational study of consecutively admitted patients with pleural effusion in Department of Pulmonary Medicine, J.J.M Medical College, Davangere. The study was carried out on 50 patients with pleural effusions. Detailed history, physical examination was done along with correlation of radiological, biochemical and cytological investigation. Sample size taken for convenience. RESULTS In this prospective observational study of 50 patients with pleural effusion, the mean age was 45.4 ± 17.67 years and two thirds were men. The three most common causes of pleural effusion in this study were tuberculosis (60%) followed by empyema (12%), transudative (10%) and parapneumonic effusion (10%) respectively. Among the transudative pleural effusion, congestive heart failure was most common cause. The patients with TB were young. The most common symptoms encountered by them were cough (83.33%), followed by fever (56.67%) and chest pain (36.67%). Empyema was the 2ndmost common cause of pleural effusion in the study, cough was the predominant symptom (83.33%), followed by chest pain (50%) and breathlessness (50%) in the study population. Right sided effusion was most common with male to female ratio of 1.94:1. Pleural fluid ADA proved to be a good diagnostic indicator in TB effusion. ADA more than 70 IU/L was associated with nearly half of Tubercular effusions. Empyema was most commonly associated with high total cell counts, with predominant neutrophils, pleural fluid glucose <40 mg%, Pleural LDH to serum LDH ratio >2. CONCLUSION In pleural effusion, TB effusion remained to be the most common cause, which was diagnosed symptomatically, diagnostically with the aid of Lymphocyte: Neutrophil ratio, colour of pleural fluid and ADA levels, LDH, pleural fluid glucose. Total count helped in diagnosis of empyema and parapneumonic effusions. Congestive heart failure remained to be most common cause of transudative effusion, managed conservatively. Early diagnosis, early initiation of antitubercular drugs in TB effusion, early intervention and treatment like ICD procedures in cases of empyema and parapneumonic effusion showed improvement and signs of recovery in pleural effusion patients.
Authors and Affiliations
Akshay M. Hiremath, Dharma U. Shetty, Patre Rachita
Keywords
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