After the primary evaluation of undiagnosed pleural effusions (fluid on the lungs), which clinical conditions must be met before discontinuing further evaluation?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Among patients with undiagnosed pleural effusions after the primary evaluation, those who meet all 6 of the following clinical parameters are predicted to have a benign course, and no further evaluation is necessary:

  • Patients are clinically stable

  • Patients do not have weight loss

  • The results of the purified protein derivative (PPD) test, used in detecting tuberculous pleural effusion, are negative and the pleural adenosine deaminase (ADA) value, also used in diagnosing tuberculous pleural effusion, is less than 43 U/mL

  • The patient does not have a fever

  • The pleural fluid differential blood cell count has less than 95% lymphocytes

  • The effusion occupies less than 50% of the hemithorax


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