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- Pleural effusion - summary of tests to consider
Pleural effusion - summary of tests to consider
Protein
LDH
Glucose - <3.3mmol/L associated with empyema, rheumatoid disease, SLE, TB, malignancy
pH - <7.2 indicates pleural infection and is an indication for drainage if parapneumonic
WCC and differentials
Neutrophils - PE, pancreatitis, pneumonia, empyema
Lymphocytes - Cancer, TB pleuritis, CCF
Eosinophila – Pneumothorax, haemothorax, asbestosis, Churg-Strauss
Mononuclear cells - Chronic inflammatory process
Cytology – malignant effusions
Amylase – not routine. Useful in oesophageal rupture or effusions associated with pancreatic disease
HCT – suspicion of haemothorax
Gram stain and culture – use blood culture bottles and specimen jars, especially if chronic illness or suspect TB or fungus
Remember to take serum protein and LDH for comparison
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