APPROACH TO ETIOLOGIC DIAGNOSIS OF PLEURAL FLUID

Dr. Anjali P. Ghare, Dr. Vikash Kumar

Abstract


Introduction : Pleural effusion is unusual amount of fluid that accumulates around the lung in pleural space_ Various conditions can lead to accumulate abnormal pleural fluid when the treatment target is likely  to drain it Aim : To study different causes and treatment modalities for patients of pleural effusion Materials And Method : In the institute during the period from May 2017 to April 2018, 80 patients studied with detailed history, lab investigations and treatment given documented. All patients followed short term approximately two weeks in detailed. Results : Tuberculosis was most common cause found other than malignant Para pneumonic effusion, C.C.F. anemia, hyperproteinemia ._ Conclusion : Most patients presented with signs and symptoms of cardio- respiratory distress. pleural fluid analysis is most important finding of diagnosis than FNAC in needed patients for confirmation of malignancy.

 


Keywords


Tuberculosis, Pleural effusion, C.C.F, Para pneumonic effusion, anemia, hypoprotenimia malignancy.

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References


Laboratory study. Patients were followed up for pleural fluid presence if necessary. Ultra sonography for detection of small amount of fluid detection till recovery.

RESULTS

-Eighty patients of pleural effusion included in the study. pleural fluid study reveals most were exudative with increase protein, decrease glucose and increase lymphocytes. Few with increase polymorphs. Pleural fluid AFB +ve in 10% and bacteria in 5% These above are possible for etiological diagnosis. On the basis of laboratory studies remaining patients advised for CT scan with contrast for diagnosis & those who needed for bronchoscopy & FNAC for confirmation of for diagnosis & related cause.

Tabel showing diagnostic analysis after examination of pleural fluid.

Detected Conditions No. of patients Percentage

Anemia & hyoeroriteinemia 5 6.25%

CCF 5 6.25%

Para pneumonic effusion 10 12.5%

Malignancy 6 7.5%

Tuberculosis 50 62.5%

Pleural fluid tapping done & in tuberculous effusion patients anti TB drugs started in Para pneumonic effusion antimicrobial therapy started. In patients of anemia, hyperporteinemia & CCF treatment for cause given. Malignancy patients refer to higher center for radiotherapy and chemotherapy.

DISCUSSION

In this study majority patients presented with symptoms of cardio respiratory distress Tuberculosis being common cause in most of the

patients. In our study pleural fluid with ADA examination by lights criteria ware remarkably effective in achieving goal (4,9) . All pleural fluid study with 60% exudates & 40% transudates (10) X-ray & CT thorax with contrast played major role in diagnosing malignancy. Pleural fluid tapping & treatment for cause was management for pleural criteria (1,5,8) . This study matches to "Study of 100 cases of pleural effusion with reference diagnostic approach" (3) .

CONCLUSION :

Form our study pleural fluid examination with ADA & lights criteria is most important for diagnosis of pleural effusion. Tuberculosis is major common cause for pleural effusion. Treatment for cause is treatment modality for successful outcome.

REFERENCES

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