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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Pleural Effusion

Pleural Effusion

Pleural effusion is abnormal excess fluid that accumulates in pleural cavity, the fluid filled space that surrounds the lung.

The fluid can impair the breathing by limiting the expansion of the lung during inspiration.


  • Dyspnea- indicates large effusion
  • Chest pain
  • Lower extremity edema
  • Orthopnea- Dyspnea on lying down
  • Night sweats
  • Fever
  • Hemoptysis
  • Weight loss
  • Cough with or without sputum


 Types of fluids




  • Heart failure
  • Liver cirrhosis
  • Hypoalbuminemia
  • Nephrotic syndrome
  • Peritoneal dialysis
  • Myxedema


  • Carcinoma
  • Tuberculosis
  • Pancreatitis
  • Trauma
  • Collagen vascular disease
  • Pulmonary embolism
  • Asbestos exposure



  • Complete blood count
  • Chest X-ray
  • Pleural fluid aspiration and examination
  • CT thorax



Whether transudates or exudates drain large pleural effusions by needle or tube aspiration methods if causing severe respiratory symptoms

  • To treat the underlying cause
  • Restriction of fat intake helps in chylous effusion
  • Antibiotics in empyema
  • Drug Mechlorethmine used to treat pleural effusion
  • Surgical intervention required if effusions cannot be drained adequately
  • To repeat chest x-ray after fluid aspiration


Pleural effusions due to cancer (malignant effusions) carry bad prognosis.

Pleurodesis or pleural sclerosis is used to recurrent malignant effusions.

Para pneumonic effusions should be treated promptly without sequels.