Study of Clinical Profile and Diagnostic Approach in Patients with Pleural Effusion

Background: Pleural effusion, an abnormal accumulation of fluid in the pleural space, is a frequent clinical condition resulting from various pulmonary and extrapulmonary disorders. In India, tuberculosis remains a leading cause of exudative effusions, necessitating a detailed diagnostic approach to differentiate among etiologies. Objectives: To study the clinical profile and presenting symptoms of pleural effusion. To analyse radiological and laboratory findings. To determine the underlying etiological factors in patients with pleural effusion. Methods: A descriptive cross-sectional study was conducted over 12 months (June 2023?June 2024) at ACS Medical College and Hospital, Chennai. Fifty-one patients aged ?14 years with clinically and biochemically confirmed pleural effusion were included. Data were collected through clinical examination, chest radiography, pleural fluid analysis (including ADA, cytology, CBNAAT), and relevant biochemical tests. Light?s criteria were applied to classify effusions as exudative or transudative. Results: The mean age of participants was 50.21 years, with a male predominance (60.78%). Right-sided pleural effusion was more common (54.90%). The most frequent clinical presentations were breathlessness (84.31%), cough with expectoration (82.35%), and fever (70.58%). Tuberculosis accounted for 62.74% of pleural effusions, followed by synpneumonic effusions (11.76%), CCF (9.80%), and malignancy (7.84%). Exudative effusions were more prevalent (74.50%). High pleural fluid LDH and ADA levels were notable in tuberculosis-related effusions. CBNAAT was positive in 7.84% of patients, while malignant cells were detected in 4 cases. Conclusion: Tuberculosis remains the most common cause of pleural effusion in this population. Clinical symptoms and radiological findings, supported by pleural fluid ADA, LDH, cytology, and CBNAAT, are crucial for accurate diagnosis and effective management.