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]

Overview

Complications of pleural effusion can result from the disease itself or from complication of treatment procedure.

Pleural fluid can be secondarily infected and may turn into an abscess or empyema, which will need to be drained with a chest tube.
Pneumothorax can be a complication of thoracentesis procedure.

Reexpansion pulmonary edema as a complication of therapeutic thoracentesis^[1]^[2]
Postcardiac injury syndrome (PCIS)^[3]^[4]^[5]
- 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.

The expected outcome depends upon the underlying disease.

↑ Doelken P, Huggins JT, Pastis NJ, Sahn SA (2004). "Pleural manometry: technique and clinical implications". Chest. 126 (6): 1764–9. doi:10.1378/chest.126.6.1764. PMID 15596671.
↑ Okubo T, Kawada M, Suzuki Y, Kawarada Y, Kitashiro S, Okushiba S (2013). "[Reexpansion pulmonary edema following thoracentesis]". Kyobu Geka. 66 (6): 456–9. PMID 23917048.
↑ Namba R, Yamamoto Y, Nawa T, Endo K (2009). "[A case of postcardiac injury syndrome with repeated pleuritis after blunt chest trauma]". Nihon Kokyuki Gakkai Zasshi. 47 (12): 1161–5. PMID 20058698.
↑ Remetz MS, Cleman MW, Cabin HS (1989). "Pulmonary and pleural complications of cardiac disease". Clin Chest Med. 10 (4): 545–92. PMID 2689066.
↑ Stelzner TJ, King TE, Antony VB, Sahn SA (1983). "The pleuropulmonary manifestations of the postcardiac injury syndrome". Chest. 84 (4): 383–7. PMID 6617272.