Anaerobic bacterial pneumonia, lung abscess, pleural effusion/empyema

Back ground: Pleural effusion is a common clinical problem with different causes. Objective: To demonstrate clinical features and outcome of pleural effusion. Methods: Prospective descriptive study was conducted involving 110 patients with pleural effusion admitted to a resource limited hospital in Ethiopia. Results: Males and females were almost equally represented. Cough, fever and weight loss were prominent presenting symptoms accounting 90, 77.3 and 77.3 percent respectively. Right side effusion was the common presentation 50 (45.5%). Forty (37.4%) patients had HIV infection among 107 tested. Tuberculosis was the commonest cause 78 (70.9%) followed by parapneumonic effusion 36 (32.7%) and empyema 27 (24.5%). Malignant pleural effusion was detected only in one patient. Eighty one (73.6%) improved from their illness and 7 (6.4%) died. Lympocytic pleural effusion found to be associated with tuberculosis (OR = 3.942 (1.527 - 10.179), P = 0.005. There were no associations between HIV infection, anemia, elevated ESR and side of pleural effusion with tuberculosis. Conclusion: Tuberculosis was the leading cause of pleural effusion in our setup even though etiologic diagnosis was difficult. Strengthening the laboratory and pathology services in the area is strongly recommended

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“…Patients with pleural effusion have higher morbidity and mortality than patients without pleural effusion [1].…”

Section: Introductionmentioning

confidence: 96%

Pleural effusion: presentation, causes and treatment outcome in a resource limited area, Ethiopia

Mekonnen¹,

Amare²,

Alemu³

et al. 2012

Health

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“…2 It can be due to local, systemic, infectious or non-infectious causes. 3 In an area with a high incidence of tuberculosis, the commonest causes of pleural e usion include tuberculosis (25%), neoplasia (22.9%), congestive cardiac failure (17.9%) and pneumonia (14%). 4 Diagnosis of a pleural e usion begins with obtaining the patient's clinical history and doing a physical examination and is followed by chest radiography and analysis of pleural uid, Mantoux/ tuberculin skin test, staining of sputum specimens for acid-fast bacilli (AFB) and bacteriological cultures in appropriate instances.…”

Section: Introductionmentioning

confidence: 99%

Aetiological Diagnosis of Pleural Eusion: A cross sectional study

Hossain¹,

Alam²,

Paul³

et al. 2019

Bangladesh Med J

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Pleural effusion is a common clinical problem with different possible causes. It can be due to local, systemic, infectious or non-infectious causes. Aetiological diagnosis is important for proper treatment. To evaluate the aetiological diagnosis of pleural effusion of hospitalized adult patients this cross-sectional, descriptive study conducted from April to September 2012 at Bangabandhu Sheikh Mujib Medical University (BSMMU). A total of 100 cases were selected by purposive sampling. Data were collected using a structured questionnaire. Complete history was taken either from patient or accompanying attendants. Clinical examination was done and relevant investigations report were collected. Data were analyzed using statistical package for the social sciences (SPSS). The mean age of the patient was 41.2 SD± 7.4 years with a male to female ratio of 3:1. Over half (52%) of the patients were poor, 34% were middle class and 14% were rich. Over two-third (67%) of the patients were smoker and the remaining 33% were non smoker. Out of 100 patients with pleural effusion, 52 had tuberculosis and 16 patients had malignancy. Among the malignant cases 14 were found to have bronchial carcinoma and 2, had lymphoma. The remaining 32 patient had other causes of pleural effusion which included nephrotic syndrome 14, congestive cardiac failure 5, cirrhosis of liver 4, rheumatoid arthritis 3, amoebic liver abscess 2, and undiagnosed 4. Tuberculosis is the predominant cause of pleural effusion in our country and the second leading cause is malignancy. Bangladesh Med J. 2018 May; 47 (2): 29-34

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“…Patients with pleural effusion have higher morbidity and mortality than patients without pleural effusion. 3 Pleural effusions are common finding and of highly diverse aetiologies, with higher incidence of effusions secondary to non-infective pathology in the western studies compared to infective pathology in India. 4 Most of the patients are admitted to the hospital for conditions other than pleural disease, the pleura is often secondarily affected by pulmonary parenchymal disorders and other organ system dysfunction.…”

Section: Introductionmentioning

confidence: 99%

A Study of Clinical Profile, Aetiology and Outcome of Patients Presenting With Pleural Effusion

Hiremath¹,

Shetty²,

Rachita³

2019

jemds

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BACKGROUNDPleural 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 METHODSThis 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. RESULTSIn 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 2 nd most 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. CONCLUSIONIn 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.

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Anaerobic bacterial pneumonia, lung abscess, pleural effusion/empyema

Cited by 3 publications

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Pleural effusion: presentation, causes and treatment outcome in a resource limited area, Ethiopia

Pleural effusion: presentation, causes and treatment outcome in a resource limited area, Ethiopia

Aetiological Diagnosis of Pleural Eusion: A cross sectional study

A Study of Clinical Profile, Aetiology and Outcome of Patients Presenting With Pleural Effusion

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