Pleural effusion means fluid has collected in the space between the lung and the chest wall, pressing on the lung and causing breathlessness, chest pain or a heavy feeling. It is a sign of another problem, such as TB, pneumonia, heart, kidney or liver disease, or sometimes cancer, so finding the cause is essential. Dr A. Ashok Kumar in Chittoor drains and tests the fluid and treats the underlying cause.
Common symptoms of pleural effusion
- Breathlessness, worse on lying down
- Chest pain, often sharp on breathing in
- Dry cough
- Fever if infection or TB is the cause
Get urgent care if you have
- Severe breathlessness
- High fever with chest pain
- Chest pain with fainting
Emergency? Call 093448 53689 or 108, or go to the nearest hospital.
Causes and risk factors
In India, TB is a common cause. Others include pneumonia, heart failure, kidney or liver disease, and cancer.
Tests that help
Chest X-ray and HRCT chest
Pictures of the lungs. A high-resolution CT (HRCT) shows fine detail and is important for ILD, bronchiectasis, unexplained cough and lung spots. Dr Ashok arranges the right scan and explains the report with you.
Pleural fluid tap (thoracentesis)
When fluid collects around the lung, a needle is used, under local anaesthetic and often ultrasound guidance, to drain it. This eases breathing and the fluid is tested to find the cause.
Sputum and TB tests
Testing a sample of phlegm under the microscope and with rapid molecular tests finds TB germs and other infections, and shows whether TB germs are resistant to medicines.
How Dr Ashok manages it
- Chest X-ray and ultrasound to confirm and measure the fluid
- Pleural tap to relieve breathlessness and test the fluid
- Treatment of the cause: TB, infection, heart, kidney or liver disease
- Chest tube drainage when needed
- Follow-up imaging to make sure the fluid does not return
Living well
- Complete treatment for the cause
- Do breathing exercises after drainage
- Return for follow-up X-rays
Questions patients ask
Is removing the fluid painful?
It is done under local anaesthetic, so most people feel only pressure. Breathing often eases right after.
Will the fluid come back?
It may, if the cause is not treated. Treating the cause is what keeps the fluid from returning.