Causes of Pleural Effusion - Differential Diagnosis Algorithm

Exudative Effusion:

 - Pulmonary

     • Infectious

     • Neoplastic

     • Inflammatory (RA, SLE)

     • Pulmonary Embolus*

     • Chylothorax

     • Hemothorax

Gastrointestinal

     • Ruptured Esophagus*

     • Pancreatitis

Transudative Effusion:

 - Increased Hydrostatic Pressure

     • Congestive Heart Failure

     • Renal Failure with Hypervolemia

     • (Early) Pulmonary Embolus

 - Decreased Oncotic Pressure

     • Cirrhosis

     • Nephrotic Syndrome

Light's Criteria:

 - Pleural Fluid Protein/Serum Protein > 0.5

 - Pleural Fluid Lactate Dehydrogenase (LDH)/Serum LDH > 0.6

 - Pleural Fluid LDH > 2/3 Serum LDH Upper Limit of Normal



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