Etiological Profile of Pleural Effusion: A Single Center Study

Background: Pleural effusion (PE) is the buildup of fluid around the lungs, commonly categorized as exudative or transudative. Exudative PE can result from various factors, while transudative PE is often linked to conditions like heart failure or cirrhosis. Diagnosing PE involves understanding its diverse causes, including infections, inflammation, and malignancies. Around 400,000 to 500,000 cases occur annually in Germany, with non-malignant cases having a significant mortality rate. Understanding PE’s etiology is crucial for effective treatment, highlighting the importance of thorough evaluation and management strategies.

Aim of the Study: The aims of this study were to determine the etiology of PE and clinical characteristics of individuals admitted to KMCH.

Methods: This study, conducted at Khulna Medical College and Hospital, spanned from 2022 to 2023 and involved 33 patients with pleural effusion. Inclusion criteria comprised all types of pleural effusion in individuals aged 18 to over 60, irrespective of gender, while exclusion criteria excluded those under 18, hemodynamically unstable, and pregnant women. Data collection included demographic information, medical history, and diagnostic investigations such as complete hemogram, chest X-ray, and various fluid analyses. Data were organized, inputted into Microsoft Excel, and analyzed using SPSS version 26.

Results: The study examined 33 cases of pleural effusion, with a majority aged 21-40 years (51.51%). Males comprised 63.64% of participants. Right-side effusion was most common (63.64%), followed by left-side (33.33%) and bilateral involvement (3.03%). Dyspnea (72.73%) was the most common symptom, followed by cough (57.58%) and fever (51.52%). Straw-colored fluid (49%) was the most prevalent, with tuberculosis as the leading cause (60.61%) of exudative effusion. Transudative causes accounted for 12.12%, including congestive cardiac failure and cirrhosis. Pleural fluid analysis was the most common investigation (51.52%), followed by sputum for AFB and lymph node fine-needle aspiration cytology (18.18% each).

Conclusion: This study underscores the diverse causes of pleural effusion, highlighting the need for thorough evaluation for accurate diagnosis and management. Exudative effusions, with tuberculosis as a prominent cause, predominate. Clinical symptoms vary, with dyspnea being the most common. Fluid appearance aids diagnosis. A nuanced approach is crucial for effective treatment and patient outcomes.

Keywords: Etiological, Pleural fluid and Pleural Effusion.