CLINICAL AND ETIOLOGICAL CHARACTERISTICS OF UNILATERAL PLEURAL EFFUSION

Introduction: Unilateral pleural effusion (UPE) has varied causes, notably tuberculosis (TB), malignancy, and parapneumonic infections. In India, TB remains a leading etiology, but regional data are essential for targeted management. Our study aimed to assess the clinical, demographic, biochemical, and etiological proles of UPE in a tertiary care center in Rajasthan. Methods: This cross-sectional study included 150 adults with conrmed UPE at Institute of Respiratory Diseases, SMS Medical College, Jaipur (1st Oct 2023–31st Sept 2024). Clinical evaluation, imaging, pleural uid analysis (biochemistry, ADA, cytology, CBNAAT), and Light’s criteria were applied. Results: Mean age was 52.4 years; 62.7% were males and 58% from rural areas. Dyspnea (94.7%), fever (78.7%), and cough (72%) were common. TB was the most frequent cause (41.3%), followed by malignancy (25.3%), parapneumonic effusions (18.7%), and cardiac causes (8%). Most effusions (89.3%) were exudative. ADA was signicantly elevated in TB cases (mean 68.4 ± 24.6 U/L; p < 0.001), with an AUC of 0.92 at 30 U/L cutoff (sensitivity 91.9%, specicity 84.1%). Cytology had a 73.7% yield in malignancy. Conclusion: In our study, Tuberculosis was found to be most common cause of unilateral pleural effusion. ADA is a reliable marker for tuberculous pleuritis. Malignancy and parapneumonic effusions are also signicant. Region-specic use of ADA and Light’s criteria is crucial in high-burden settings.