Pleural effusion natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Complications

• Only symptomatic pleural effusions or effusions larger than 50% of hemithorax require thoracentesis or chest tube drainage.
• A lung that is surrounded by excess fluid for a long time may be damaged.
• Pleural fluid that becomes infected may turn into an abscess, called an empyema, which will need to be drained with a chest tube.
• Pneumothorax (air in the chest cavity) can be a complication of the thoracentesis procedure.
• Most resolve spontaneously.
• Postcardiac injury syndrome (PCIS)
  • A general term for fever and pleuropericardial disease days or months after cardiac injury (myocardial infarction or surgery).
  • Typically present two to three weeks post op.
    • Chest pain
    • Pericardial rub
    • Fever
    • Leukocytosis
    • Elevated erythrocyte sedimentation rate (ESR)
    • Variable combinations of pulmonary effusions and infiltrates.

Prognosis

The expected outcome depends upon the underlying disease.