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A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional ...
As already mentioned before, sensitivity of pleural fluid culture is generally low, often partly due to prior administration of antibiotics. It has been shown that culture yield can be increased from 44% to 69% if pleural fluid is injected into blood culture bottles (aerobic and anaerobic) immediately after aspiration. [11]
The pleural cavity, or pleural space (or sometimes intrapleural space), is the potential space between the pleurae of the pleural sac that surrounds each lung.A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes, and also to create a pressure gradient.
Diagrammatic view of exaggerated pleural space. Cytology of the normal mesothelial cells that line the pleurae, with typical features. [3] Wright's stain.. Each pleura comprises a superficial serosa made of a simple monolayer of flat (squamous) or cuboidal mesothelial cells with microvilli up to 6 μm (0.00024 in) long.
Serous membrane fluid collects on microvilli on the outer layer and acts as a lubricant and reduces friction from muscle movement. This can be seen in the lungs, with the pleural cavity. Pericardial fluid is a serous fluid secreted by the serous layer of the pericardium into the pericardial cavity. The pericardium consists of two layers, an ...
The criteria for a complicated parapneumonic effusion include Gram stain–positive or culture-positive pleural fluid, pleural fluid pH <7.20, and pleural fluid LDH that is greater than three times the upper limit of normal of serum LDH. [2] Diagnostic techniques available include plain film chest x-ray, computed tomography (CT), and ultrasound ...
An exudate is defined as pleural fluid to serum total protein ratio of more than 0.5, pleural fluid to serum LDH ratio > 0.6, and absolute pleural fluid LDH > 200 IU or > 2 ⁄ 3 of the normal. An exudate is defined as pleural fluid that filters from the circulatory system into lesions or areas of inflammation.
Chest x-ray is the first test done to confirm an excess of pleural fluid. The lateral upright chest x-ray should be examined when a pleural effusion is suspected. In an upright x-ray, 75 mL of fluid blunts the posterior costophrenic angle. Blunting of the lateral costophrenic angle usually requires about 175 mL but may take as much as 500 mL.