title: The undiagnosed pleural effusion.
abstract: The most common causes for undiagnosed transudative effusions are congestive heart failure and hepatic hydrothorax. Pleural fluid N terminal pro-brain natriuretic peptide levels higher than 1500 pg/mL are virtually diagnostic of congestive heart failure. The most common causes for undiagnosed exudative pleural effusions are malignancy, pulmonary embolism, and tuberculosis. Clinical characteristics of patients with a malignant pleural effusion are symptoms for more than 1 month, absence of fever, blood-tinged pleural fluid, and CT findings suggestive of malignancy. Thoracoscopy is useful to establish the diagnosis of malignancy and tuberculosis.
authors.affiliation: Vanderbilt University, T-1218 Medical Center North, Nashville, TN 37232-2659, USA. rlight98@yahoo.com
authors.forename: Richard W
authors.initials: RW
authors.lastname: Light
mesh_terms: D001999:Bronchoscopy; D006333:Heart Failure / Q000150:complications; D006801:Humans; D010808:Physical Examination; D010996:Pleural Effusion / Q000175:diagnosis*; D013906:Thoracoscopy