Exudates of an inflammatory nature. Differential diagnosis includes rheumatoid arthritis, SLE, sarcoidosis, TB, pancreatitis, esophageal rupture. Illnesses that can cause exudates or transudates include trauma, neoplasms, infection, pulmonary embolism, idiopathic. Generally have dyspnea, tachycardia, and orthopnea. The course of symptom onset is variable and may be either abrupt or gradual.
Chest radiograph shows effusion.
Will layer out on recumbency if not loculated. May have fluid in fissures, blunting of the costophrenic angles. Send fluid for specific gravity, pH, glucose, cell count, differential diagnosis, amylase, total protein, LDH, culture for aerobes, anaerobes and mycobacteria, Gram stain, AFB stain, cytologic analysis, CEA as indicated. Under 1.016 is suggestive of a transudate. Consider abdominal CT if suspect lymphoma.