Clinical Profile and Etiological Spectrum of Exudative Pleural Effusion

Abstract

Background: Exudative pleural effusion is commonly caused by tuberculosis and malignancies, often presenting significant diagnostic challenges in clinical practice. The need to combine clinical characteristics with a cost effective and targeted approach towards making a definitive diagnosis cannot be overemphasized. This study examines the clinical presentation, demographic characteristics, and etiological spectrum of exudative pleural effusion in a Nigerian tertiary care setting. Methods: This prospective study involved 58 patients, aged 19 to 87 years who were referred to the cardiothoracic unit of the University of Benin Teaching Hospital over a period of one year with undiagnosed exudative pleural effusion. The demographics, clinical presentation and investigations including laboratory, radiological and pleural fluid characteristics were recorded. The data were subsequently analyzed using SPSS version 25, with results expressed as frequencies, percentages, means, and standard deviations. Results: The study revealed malignancy (50%) and tuberculosis (43.2%) as the leading causes of undiagnosed exudative pleural effusion in our environment. Dyspnea (91.4%), cough (87.9%), and chest pain (79.3%) were the most common symptoms. It also demonstrated male preponderance with a male to female ratio of 1.1:1 and a mean age of 51.16±17.487. Left sided effusion predominates (56.9%) as compared to the right (43.1%). Hemorrhagic effusion featured prominently in cases of malignancy (82.8%) while turbid effusion was commoner in cases of tuberculosis (72.0%). Conclusion: These findings highlight the need for a thorough clinical evaluation and targeted diagnostic strategies to optimize patient outcomes.