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Pleural Effusion

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(See Chapter 13, Thoracentesis, for more details.)

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Transudate:

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(Pleural to serum protein ratio < 0.5, pleural to serum LDH ratio < 0.6, and pleural LDH < 2/3 the upper limit of normal for serum LDH), CHF, cirrhosis, nephrotic syndrome, peritoneal dialysis

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Exudate:

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(Pleural to serum protein ratio > 0.5, pleural to serum LDH ratio > 0.6, or pleural LDH > 2/3 the upper limit of normal for serum LDH), bacterial or viral pneumonia, pulmonary infarction, TB, rheumatoid arthritis, SLE, malignancy (most common, breast, lung lymphoma, leukemia, ovarian, unknown primary, GI, mesothelioma), pancreatitis, pneumothorax, chest trauma, uremia, peritoneal dialysis

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Chylothorax:

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Traumatic or postoperative complication

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Empyema:

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Bacteria, fungi, TB, trauma, surgery

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Hydrothorax:

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Usually iatrogenic (central venous catheter complication)

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