Differential Diagnosis for Pleural Effusion
Single Most Likely Diagnosis
- Congestive Heart Failure (CHF): This is the most common cause of pleural effusion, especially in older adults. CHF leads to fluid overload, causing fluid to accumulate in the pleural space.
Other Likely Diagnoses
- Pneumonia: Bacterial, viral, or fungal infections can cause pleural effusion, especially if the infection spreads to the pleura.
- Malignancy: Lung cancer, breast cancer, and lymphoma are common causes of malignant pleural effusion.
- Pulmonary Embolism (PE): A PE can cause pleural effusion, especially if it is large or recurrent.
- Nephrotic Syndrome: Severe proteinuria and hypoalbuminemia can lead to fluid accumulation in the pleural space.
Do Not Miss Diagnoses
- Tuberculosis (TB): TB is a rare but important cause of pleural effusion, especially in endemic areas or in immunocompromised patients.
- Esophageal Rupture: A rupture of the esophagus can lead to a pleural effusion, which can be life-threatening if not promptly diagnosed and treated.
- Trauma: Traumatic injuries, such as a rib fracture or a penetrating wound, can cause a pleural effusion.
Rare Diagnoses
- Asbestos-Related Disease: Asbestos exposure can cause pleural effusion, especially in individuals with a history of asbestos exposure.
- Sarcoidosis: This autoimmune disease can cause pleural effusion, although it is a rare manifestation of the disease.
- Lymphangioleiomyomatosis (LAM): A rare lung disease that can cause pleural effusion, especially in women of childbearing age.
- Chylothorax: A rare condition where lymphatic fluid accumulates in the pleural space, often due to trauma or malignancy.