Etiological diagnosis of Pleural effusion in Hundred cases

Baburaj, K (2006) Etiological diagnosis of Pleural effusion in Hundred cases. Masters thesis, Coimbatore Medical College, Coimbatore.


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In Our Study 100 cases of pleural effusion were taken up and we found that the incidence is more common in males than in females. It has been found that Tuberculosis is the most common cause of pleural effusion as it is the most prevalent infectious disease in India. Out of the 100 cases 66 patients were to be of Tuberculous etiology. Tuberculous pleural effusion with clinical presentation (66 cases, 66%): Out of 66 cases of Tuberculous pleural effusion majority of cases were presented with the following manifestations like cough with expectoration, sputum, chest pain, fever, loss of appetite and loss of weight. Apart from the above Symptomatology, dyspnoea and hemoptysis were present. Malignant Effusion (10 cases, 10 %): Out of 10 neoplastic conditions eight presented with effusion primarily of lung pathology in the form of Adenocarcinoma and Squamous cell carcinoma. The patient with Squamous cell carcinoma presented with cough, chest pain, hemoptysis, dyspnoea, clubbing and enlarged Left Supraclavicular node. The Adenocarcinoma patient apart from the above symptoms also presented with secondaries in the skull and facial palsy and deafness. The other 2 were found to be serous papillary cystadenocarcinoma of ovary and Hodgkins lymphoma (1 case). The patient with serous papillary cystadenocarcinoma of ovary presented as painful lower abdominal lump. The patient with Hodgkins lymphoma (1 case) presented with symptoms of Mediastinal mass with chest pain and breathlessness other one presented with generalized lymphadenopathy, fever and weight loss. Cardiac failure with pleural effusion (15 cases, 15%): All cases were due to post infarction failure. They presented with symptoms of anginal chest pain, palpitation, paroxysmal nocturnal dyspnoea, Orthopnoea and cough. Pleural Effusion Due To Renal Disease (3 cases, 3%): Nephrotic Syndrome with Pleural Effusion (1 case): The patient presented with puffiness of face, generalized edema, dyspnoea and cough. Diabetic nephropathy with pleural effusion (2 cases): Diabetic nephropathy leading on to chronic renal failure presented with easy fatigability, puffiness of face, oliguria, volume overload and dyspnoea. Cirrhosis with pleural effusion (2 cases): The patient presented with abdominal distention hemetemesis, B/L pedal edema, oliguria, loss of appetite and other evidence of portal hypertension. Acute Pancreatitis (2 cases): `Patient presented with acute abdominal pain, vomiting, hemetemesis, dehydration and hypovolemic shock. Pyogenic effusion (2 cases): Both patients presented with high grade fever associated with rigor and chills, dyspnoea and the patient was found to be toxic and delirious. The pus cultures were positive for Proteus in one and Staph. aureus in the other. Study done by Govindasamy et al., 1985 shows 73.3% Tuberculous pleural effusion, 16.7% due to malignant pleural effusion, 6.7% were due to cardiovascular disease and 3.3% were due to liver disease. In our series, etiological causes of pleural effusion are as follows: 66% due to Tuberculosis, 10% due to Malignancy, 15% due to Cardiac disease, 3% due to Renal disease, 2% due to Pyogenic effusion, 2% due to Acute pancreatitis, 2% due to Liver disease. According to Harrison’s principles of internal Medicine 16th edition 2005, the most commonest cause of pleural effusion in cardiac disease is Left ventricular failure. In our study also all the Fifteen cardiac disease patients with pleural effusion are due to Left ventricular failure. According to Oxford Text Book of Medicine, 4th edition 2003, in acute pancreatitis with pleural effusion the ratio between pleural fluid Amylase/ serum amylase > 1. in our study also acute pancreatitis with pleural effusion, the ratio of pleural fluid amylase 350 S units/L / serum amylase 200 S units/L is > 1.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Etiological diagnosis ; Pleural effusion ; Hundred cases.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 17 Feb 2018 12:44
Last Modified: 17 Feb 2018 12:55

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