Pleural effusion natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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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.

The expected outcome depends upon the underlying disease.