Clinical Presentations and Complications among Patients with Undiagnosed Exudative Pleural Effusion

Background: Pleural effusion is a common clinical finding with diverse causes, including congestive heart failure, parapneumonic effusion, and tuberculosis. When etiology remains unknown, it poses significant diagnostic and management challenges.Aim: To describe clinical presentations and complications in patients with undiagnosed exudative pleural effusion.Patients & Methods: This prospective, single-center interventional study included 100 adults (>18 years) with undiagnosed exudative pleural effusion presenting to Suez Canal University Teaching Hospital, Cardio-thoracic Department, Clinic, and Emergency Unit between July 2022 and December 2023. Exclusion criteria were bleeding diathesis, severe COPD, unstable cardiovascular disease, trapped lung, and inoperable transudative effusion. Collected data included demographics, medical history, and clinical evaluation.Results: Dyspnea was the most common symptom (95.0%), followed by cough (47.0%), chest pain (44.0%), weight loss (42.0%), and fever (40.0%). Adverse events were rare: subcutaneous emphysema occurred in 2.0% of patients, fever in 3.0%, and pleural space infection in 1.0%.Conclusion: Dyspnea is the predominant presentation of undiagnosed exudative pleural effusion, with other symptoms including cough, chest pain, weight loss, and fever. Complications are infrequent, with a low incidence of subcutaneous emphysema, fever, and infection, suggesting a generally safe clinical course in this patient group.