Med-Spot on Med-Source: Interpreting Pleural Effusion Fluid

Med-Spot - Interpreting Thoracentisis Analysis - Diagnostic Hints from Pleural Fluid

Characteristics of Pleural Fluid
Etiology	Appearance	WBC (diff)	RBC	pH	Glucose	Misc.
CHF	clear, straw	<1000>	<5,000	nl.	~serum	bilat. cardiomegaly
cirrhosis	clear, straw	<1000	<5,000	nl.	~serum	R-sided
uncomplicated parapneumonic	turbid	<40,000>	<5,000	nl. → ↓	~serum
complicated parapneumonic	turbid → purulent	<100,000>	<5,000	↓↓	↓↓	needs drainage
empyema	purulent	<100,000>	<5,000	↓↓↓	↓↓	needs drainage
TB	serosang.	<10,000>	<10,000	nl. → ↓	nl. → ↓	+ AFB, + ADA
malignancy	turbid → bloody	<100,000>	<100,000	nl.	nl. → ↓	cytology
PE	sometimes bloody	<50,000>	<100,000	nl	~serum	no infarct → transudate
RA	turbid	<20,000>	<1,000	↓	↓↓↓	↑RF, ↓ CH50
pancreatitis	serosang. → turbid	<50,000>	<10,000	nl.	~serum	L-sided, ↑amylase
esophageal rupture	turbid → purulent	can be > 50,000	<10,000	↓↓↓	↓↓	L-sided, ↑amylase