scholarly journals Role of bronchoscopy in pleural effusion bacterial infection

2020 ◽  
Vol 7 (3) ◽  
pp. 523
Author(s):  
Gomathi R. G. ◽  
Sindhura Koganti ◽  
Dhanasekhar . ◽  
Chandrasekar . ◽  
Rajagopalan .
Keyword(s):  
Pleural Effusion ◽  
Bacterial Infection ◽  
Bacterial Growth ◽  
Ultrasound Examination ◽  
Underlying Disease ◽  
Pleural Effusions ◽  
Etiological Diagnosis ◽  
X Ray ◽  
Definite Role

Background: In the present study was to investigate that the role of Bronchoscopy in pleural effusion in bacterial growth condition. Pleural effusion is one of the commonest problems with which patients present to the hospital. Pleural effusion is always abnormal and indicates the presence of an underlying disease. Despite the fact that there are many causes of pleural effusion, it is estimated that 90% of all pleural effusions are the result of only 5 disease processes: malignancy, pneumonia, pulmonary embolism viral infection, congestive heart failure.Methods: This is a Prospective and Observational Study. All patients diagnosed to have pleural effusion by x-ray, clinical examination and ultrasound examination of pleura if needed will undergo informed.Results: All 80 patients were included of whom 60(70%) were males and 20(30%) were females. Out of 80 patients, 5 patients are having bacterial growth (6.3%). All 5 patients who had exudative effusion, 4 were males and 1 female, 4 cases were right side effusion and 1 left sided effusion.Conclusions: Authors conclude that bronchoscopy has a definite role in the etiological diagnosis of pleural effusion in bacterial infection.

scholarly journals Diagnosis dan tatalaksana terbaru penyakit pleura

2020 ◽  
Vol 2 (1) ◽  
pp. 69-78
Author(s):  
Ni Putu Nita Pranita
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Malignant Pleural Effusion ◽  
Bronchopleural Fistula ◽  
Disease Process ◽  
Standard Of Care ◽  
Underlying Disease ◽  
Pleural Disease ◽  
Pleural Effusions

Pleural effusion is a common problem. Pleural effusion developed as a sequel to the underlying disease process, including pressure/volume imbalance, infection, and malignancy. In addition to pleural effusion, persistent air leak after surgery and bronchopleural fistula remain a challenge by a physician. An understanding of the pleural disease, including its diagnosis and management, has made an extraordinary step. The introduction of molecular detection of organism-specific infections, risk stratification, and improvement in the non-surgical treatment of patients with pleural infection are all within reach and maybe the standard of care shortly. This article discusses the role of existing techniques, and some of the more recent ones, which are now available for establishing the diagnosis of pleural disease. The initial approach to diagnosis usually begins by distinguishing between transudates and exudates, based on the concentration of protein and lactate dehydrogenase (LDH) in pleural fluid. The exact role of amylase and LDH can provide additional information towards the differential diagnosis of various exudative pleural effusions. With newer cytochemical staining techniques in pleural fluid, diagnostic results of malignant pleural effusion can increase by up to 80%. Ultrasound (US) and thoracic computed tomographic (CT) scans have further improved the diagnosis of undiagnosed pleural effusion. The reappearance of thoracoscopy as the latest diagnostic and therapeutic tool (e.g., Pleurodesis) for undiagnosed or recurrent pleural effusions. Management of malignant pleural effusion continues to develop with the introduction of tunneled pleural catheters and chemical pleurodesis procedures. Advances in the diagnostic and therapeutic evaluation of pleural disease and what appears to be an increasing multidisciplinary interest in a doctor managing patients with pleural disease.

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

scholarly journals The Role of Cytokine profile detection in Myelomatous pleural effusions

2021 ◽  
Author(s):  
Junhui Xu ◽  
Liang Gao ◽  
Miao Yan ◽  
Bingjie Wang ◽  
Zhengyang Song ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pleural Effusion ◽  
Cytokine Profile ◽  
Pleural Effusions ◽  
Case Presentation ◽  
Cytokine Detection ◽  
Tnf Α ◽  
Tumor Load ◽  
Poor Outcomes

Abstract Background: Myelomatous pleural effusion (MPE), as a presentation of extramedullary infiltration of multiple myeloma (MM), is rare and associated with poor outcomes without comparatively effective treatment now. The value of the cytokine detection in pleural effusions to MPE has not been reported at present. Case presentation: We herein report a case of refractory and relapsed multiple myeloma which developed bilateral MPE due to disease progression caused by intolerance to various chemotherapy regimens. The cytomorphology and flow cytometry is adopted in the diagnosis confirmation. The chemotherapy containing immunomodulators combined with thoracic catheterization drainage is applied to the patient, showing a certain therapeutic effect. During the course of disease, the changes of cytokine profile in pleural effusion were monitored by Biolegend CBA technology, revealing that the cytokines such as IL-6 and IL-10 related to the tumor load in pleural effusion decreased with the improvement of the disease, while IL-2, IL-4, IL-17A, TNF - α, INF - γ, granzyme A, Granzyme B, perforin and granulysin increased with the improvement of the disease. Conclusions: There is a prospect that the cytokines level in pleural effusion becomes an indication to evaluate treatment response of MPE, and in the light of our finding, immunomodulators, IL-2 and INF - γ may be utilized in treating patients suffering MPE.

scholarly journals Characteristics of Chest X-Ray in Patients with Cancer at the Dharmais Cancer Hospital Emergency Room during the COVID-19 Pandemic

2021 ◽  
Vol 15 (4) ◽  
pp. 195
Author(s):  
Bima Taruna Sakti ◽  
Rosalina Rosalina ◽  
Jaka Pradipta
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Pleural Effusion ◽  
Pleural Effusions ◽  
Hospital Emergency ◽  
X Ray ◽  
Patients With Cancer ◽  
Cancer Hospital ◽  
Hospital Emergency Room ◽  
Chest X Ray

Background: Conventional chest X-ray (chest X-ray) in Dharmais Cancer Hospital emergency room (ER) is still the primary modality to diagnose patients with cancer with dyspnoea complaints. Chest X-ray was also carried out to screen inpatients at the Dharmais Cancer Hospital ER at the beginning of the COVID-19 pandemic in Indonesia. It was essential because patients in the Dharmais Cancer Hospital ER were patients with cancer, with low immunity and a high risk of being exposed to various infections. Thus, the purpose of this study was to determine the characteristics of chest X-rays in patients with cancer at the Dharmais Cancer Hospital ER during the COVID-19 pandemic in February-May 2020. Methods: This was a descriptive study. The population involved was all patients at the Dharmais Cancer Hospital ER who received chest X-ray support, with the inclusion criteria for diagnosing lung cancer, breast cancer, cervical cancer, colorectal cancer, and blood cancer (Leukemia) from February to May 2020. Data analysis employed univariate analysis by utilizing tables and graphs in presenting the data.Results: 289 samples met the research criteria. The highest visits were patients with breast cancer (41.2%). The most common thoracic images were pleural effusion (34.3%), followed by bronchopneumonia (31.1%), normal lung (16.6%), lung mass (7.6%), pneumonia (5.2%), and others (5.2%), consisting of atelectasis, bronchitis, fibrosis/chronic pulmonary process, pulmonary emphysema, cardiomegaly, and specific process. Besides, the chest x-ray bronchopneumonia was 31.1% (90 samples), accompanied by pleural effusion of 44.4%. From the chest X-ray, pleural effusions were 34.3% (99 samples), with lung cancer being the most common with pleural effusions (48.4%).Conclusions: More than 80% of chest x-ray performed in the ER are abnormal. Also, breast cancer is the highest in the Dharmais Cancer Hospital ER cases, with the highest chest x-ray of pleural effusion.

Management of pleural effusion and haemothorax

2016 ◽  
Author(s):  
Davide Chiumello ◽  
Silvia Coppola
Keyword(s):  
Pleural Effusion ◽  
Symptomatic Relief ◽  
Underlying Disease ◽  
Pleural Space ◽  
Bacterial Invasion ◽  
Pleural Effusions ◽  
Management Options ◽  
External Drainage ◽  
Malignant Effusions ◽  
Pleural Catheter

The main goal of management of pleural effusion is to provide symptomatic relief removing fluid from the pleural space. The options depend on type, stage, and underlying disease. The first diagnostic instrument is the chest radiography, while ultrasound can be very useful to guide thoracentesis. Pleural effusion can be a transudate or an exudate. Generally, a transudate is uncomplicated effusion treated by medical therapy, while an exudative effusion is considered complicated effusion and should be managed by drainage. Refractory non-malignant effusions can be transudative (congestive heart failure, cirrhosis, nephrosis) or exudative (pancreatitis, connective tissue disease, endocrine dysfunction), and the management options include repeated therapeutic thoracentesis, in-dwelling pleural catheter for intermittent external drainage, pleuroperitoneal shunts for internal drainage, or surgical pleurectomy. Parapneumonic pleural effusions can be classified as complicated when there is persistent bacterial invasion of the pleural space, uncomplicated and empyema with specific indications for pleural fluid drainage. Malignancy is the most common cause of exudative pleural effusions in patients aged >60 years and the decision to treat depends upon the presence of symptoms and the underlying tumour type. Options include in-dwelling pleural catheter drainage, pleurodesis, pleurectomy, and pleuroperitoneal shunt. Haemothorax needs to be differentiated from a haemorrhagic pleural effusion and, when suspected, the essential management is intercostal drainage. It achieves two objectives to drain the pleural space allowing expansion of the lung and to allow assessment of rates of blood loss to evaluate the need for emergency or urgent thoracotomy.

scholarly journals Pleural effusion in sarcoidosis patients

2020 ◽  
Vol 98 (9) ◽  
pp. 64-69
Author(s):  
N. A. Stogova
Keyword(s):  
Pulmonary Embolism ◽  
Pleural Effusion ◽  
Pulmonary Sarcoidosis ◽  
Parietal Pleura ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Etiological Diagnosis ◽  
Oncological Diseases

The article presents the review of 62 publications which demonstrated that 1.1-16.7% of patients with pulmonary sarcoidosis develop plural effusion. Data from thoracoscopic examinations with pleural biopsy in sarcoidosis revealed damage to both the visceral and parietal pleura which manifested through hydrothorax, chylothorax, and hemothorax. Among patients with pleural effusions of various etiology, pleural sarcoidosis is detected in 1.5-4.0% of cases. However, pleural effusion in patients with sarcoidosis can also be caused by concomitant diseases (tuberculosis, mycosis, cardiac, renal, and hepatic failures, pulmonary embolism, pneumonia, and oncological diseases). In this regard, it is advisable to perform morphological verification for the etiological diagnosis of pleural effusion in sarcoidosis patients.

scholarly journals Role of pleural biopsy in etiological diagnosis of pleural effusion

Lung India ◽  
2010 ◽  
Vol 27 (4) ◽  
pp. 202 ◽  
Author(s):  
Sudipta Pandit ◽  
ArunabhaDatta Chaudhuri ◽  
SourinBhuniya Saikat Datta ◽  
Atin Dey ◽  
Pulakesh Bhanja
Keyword(s):  
Pleural Effusion ◽  
Pleural Biopsy ◽  
Etiological Diagnosis

Pathophysiology and causes of haemoptysis

2016 ◽  
Author(s):  
Francesco Blasi ◽  
Paolo Tarsia
Keyword(s):  
Pleural Effusion ◽  
Symptomatic Relief ◽  
Underlying Disease ◽  
Pleural Space ◽  
Bacterial Invasion ◽  
Pleural Effusions ◽  
Management Options ◽  
Indwelling Pleural Catheter ◽  
Malignant Effusions ◽  
Pleural Catheter

The main goal of management of pleural effusion is to provide symptomatic relief removing fluid from pleural space and the options depend on type, stage and underlying disease. The first diagnostic instrument is the chest radiography while ultrasound can be very useful to guide thoracentesis. Pleural effusion can be a transudate or an exudate. Generally a transudate is uncomplicated effusion treated by medical therapy, while an exudative effusion is considered complicated effusion and should be managed by drainage. Refractory non-malignant effusions can be transudative (congestive heart failure, cirrhosis, nephrosis) or exudative (pancreatitis, connective tissue disease, endocrine dysfunction), and the management options include repeated therapeutic thoracentesis, indwelling pleural catheter for intermittent external drainage, pleuroperitoneal shunts for internal drainage, or surgical pleurectomy. Parapneumonic pleural effusions can be divided in complicated when there is persistent bacterial invasion of the pleural space, uncomplicated and empyema with specific indications for pleural fluid drainage. Malignancy is the most common cause of exudative pleural effusions in patients aged >60 years and the decision to treat depends upon the presence of symptoms and the underlying tumour type. Options include indwelling pleural catheter drainage, pleurodesis, pleurectomy and pleuroperitoneal shunt. Hemothorax needs to be differentiated from a haemorrhagic pleural effusion and when is suspected the essential management is the intercostal drainage. It achieves two objectives to drain the pleural space allowing expansion of the lung and to allow assessment of rates of blood loss to evaluate the need for emergency or urgent thoracotomy.

Pleural Effusions: Pathophysiology and Management with Intrapleural Tetracycline

1988 ◽  
Vol 22 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Michael A. Oszko
Keyword(s):  
Side Effects ◽  
Pleural Effusion ◽  
Low Cost ◽  
Pleural Space ◽  
Pleural Effusions ◽  
First Line ◽  
Disease States ◽  
Ready Availability ◽  
Low Toxicity

Chronic or recurrent pleural effusions are a consequence of a variety of disease states and may produce significant pain or discomfort in a patient. Both surgical and pharmacological attempts to control pleural effusions have been tried, with moderate success. This article reviews the pathophysiology of pleural effusion and the role of intrapleural tetracycline in its management. Irritating chemicals, when instilled into the pleural space, are known to produce adhesion of the pleural membranes. Tetracycline has been shown in both animal and human studies to be effective in preventing the recurrence of a pleural effusion while producing only minor side effects, such as fever and pleuritic pain. Studies involving tetracycline in treating pleural effusions are reviewed, and guidelines for the preparation and administration of intrapleural tetracycline are presented. Because of its efficacy, low toxicity, ease of preparation, ready availability, and low cost, tetracycline deserves strong consideration as a first-line agent in the management of recurrent pleural effusions.

Sign in / Sign up

Export Citation Format

Share Document