Pleural Effusion

Clinical Features: [post id="1533" title=" For Disease Details click"]

1)Chest pain

2)Dry, nonproductive cough

3)shortness of breath

4)Fever

O/E:

1)Restricted movement on affected side

2)percussion-stony dull on affected side

3)Trachea & Apex beat are shifted opposite side

4)Breath sound & vocal resonance diminished

Investigations: 

• 1)CXR -dense homogeneous opacity with cresentic shadow & costo& cardiophrenic angle obliteration([post id="211" title="x-ray-finding"])
• 2)Pleural fluid study
• 3) Usg of chest
• 4)CT Scan of chest-to see primary site & extent of lesion
  
• 5)CBC-lymphocytic or neutrophilic leukocytosis 
• 6)ESR-high
• 7) Sputum for AFB & Gram staining
• 8) MT test ([post id="178" title="Mantoux-test-details"])

Rx:

1.Diet-Normal 

2. Bed Rest

3. O2 inhalation & propped up position if severe case

4. Tab.Napa ([post id="449" title="Paracetamol"])(500mg)/ Napadol[post id="452" title="Paracetamol+Tramadol"].

1+1+1(if fever/mild pain)

5. Cap.Betamox ([post id="402" title="Amoxicillin"])(500mg)

1+1+1......7 days

6. Therapeutic Aspiration:

• pleural fluid aspiration for study and reduce Breathlessness

7. Treatment of underlying cause

• if TB- Anti-TB drug
  
• if Pneumonia-proper antibiotics
  
• if malignancy – cytotoxic drugs

Self-care:

1)Use pressure to decrease pain. Hold a pillow against your chest when you cough or take a deep breath.

2)Do not smoke , and do not allow others to smoke around you. 

3)Drink liquids as directed and rest as needed.

4)Deep breathing and coughing will decrease your risk for a lung infection.