Evaluation of a parapneumonic effusion#
| Analysis | |
| Biochemical | pH, glucose, protein, LDH |
| Cytological | Differential counts, exclusion of tumour cells |
| Microbiological | Stains and cultures for pyogenic bacteria, consider stains and cultures for mycobacteria |
LDH: lactate dehydrogenase. The process of evaluation is as follows: 1) confirm presence of exudate; 2) exclude complicated effusion or empyema, otherwise place chest drainage; 3) exclude malignancy; and 4) adjust treatment in case of identification of specific pathogen. #: perform pleural puncture if pleural effusion exceeds 500 mL.