Differential Diagnosis for Right Sided Pleural Effusion
Single Most Likely Diagnosis
- Congestive Heart Failure (CHF): This is often the most common cause of pleural effusions, including right-sided ones. CHF leads to fluid buildup in the lungs, which can cause pleural effusions. The right side can be affected alone or more significantly than the left due to various factors, including gravity when lying down.
Other Likely Diagnoses
- Pneumonia: Bacterial, viral, or fungal infections can cause inflammation of the lung tissue, leading to a pleural effusion. The right lung is slightly larger and has a more direct path for infections to spread from the throat.
- Pulmonary Embolism (PE): A blood clot in the lungs can cause a pleural effusion, especially if it's large or involves the right lung more significantly.
- Liver Disease (Cirrhosis): Liver cirrhosis can lead to fluid buildup in the abdomen (ascites) and, through various mechanisms, cause a right-sided pleural effusion, known as hepatic hydrothorax.
- Lung Cancer: Tumors in the lung can directly invade the pleura or cause lymphatic obstruction, leading to a pleural effusion. The right lung is a common site for lung cancers.
Do Not Miss Diagnoses
- Tuberculosis (TB): Although less common in some regions, TB can cause pleural effusions and is crucial to diagnose due to its public health implications and the need for specific treatment.
- Empyema: A collection of pus in the pleural space, often due to bacterial infection, which requires prompt drainage and antibiotic treatment to prevent serious complications.
- Esophageal Perforation: A rupture of the esophagus can lead to leakage of food, saliva, and bacteria into the mediastinum and pleural space, causing a severe infection that requires immediate surgical intervention.
Rare Diagnoses
- Lymphangioleiomyomatosis (LAM): A rare lung disease that affects mostly women of childbearing age, causing cystic lung lesions and potentially leading to pleural effusions.
- Ehlers-Danlos Syndrome: A group of genetic disorders affecting connective tissue, which can lead to various complications, including spontaneous pneumothorax and potentially pleural effusions.
- Sarcoidosis: An autoimmune disease that can affect multiple organs, including the lungs, and cause pleural effusions, although this is less common.
- Asbestos-related Diseases: Asbestos exposure can lead to pleural plaques, pleural thickening, and pleural effusions, often years after the initial exposure.