International Journal of Contemporary Pediatrics | February 2024 | Vol 11 | Issue 2 Page 117
International Journal of Contemporary Pediatrics
Adnan MA et al. Int J Contemp Pediatr. 2024 Feb;11(2):117-120
http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291
Original Research Article
Pleural effusion in a pediatric ward: clinical feature, etiology and
outcome
Mohammad Ahad Adnan*, M. Delwar Hossain, M. Rezaul Haque, Tania Islam,
Ifthakhar Ahmed, Uttam Kumar Datta
INTRODUCTION
Pleural effusion is an abnormal collection of fluid in the
pleural space. It develops either owing to excessive
filtration or defective absorption of accumulated fluid. A
primary lung pathology and secondary complication of
many disorders can lead to pleural effusion.
1
The lung surface and inner chest wall surfaces are lined
by visceral and parietal pleura, respectively. Normally 4-
12 ml of fluid is present in the pleural space, that form a
thin layer of about 10 microL thickness.
1,2
In comparison
to interstitial fluid the pleural fluid has a higher level of
bi-carbonate, lower level of sodium and large molecular
weight protein (e.g. LDH) and a similar level of glucose.
3
The process of inflammation of the pleura is called
pleurisy, which may be accompanied by an effusion.
Pleurisy may be dry, serofibrinous and purulent. The
exact identification of nature is crucial in determining
treatment option and to prevent complication. Again, the
process of fluid accumulation divides the pleural effusion
ABSTRACT
Background: Pleural effusion is a common respiratory complication in children. We aimed to document clinical
feature, etiology, biochemical parameters and outcome of the admitted children with pleural effusion.
Methods: This cross-sectional study was conducted from January 2022 to June 2023 at pediatric ward of ICMH. All
children from 6 months to 14 years presented with clinical features suggestive of pleural effusion and later supported
by radiology and ultrasonography of chest either at presentation or owing to other systemic illness were enrolled.
Children aged below 6 months, associated chronic illness and parental denial of giving consent were excluded. In
indicated cases pleural fluid was tapped and sent to laboratory for physical, biochemical examination, staining,
culture, GeneXpert, LDH and ADA assay.
Results: Out of 43 children, 19 underwent pleural tap and rest were managed conservatively. Most of the children
were in between 2 to 6 years. There were 22 male and 21 female. Unilateral effusion was found in 25 children and 18
children developed bilateral effusion. All the children had documented fever. Other symptoms were cough,
respiratory distress, chest pain, weight loss, abdominal pain, jaundice and blood mixed sputum. Physical signs
correlated classical effusion features. The etiologies included DF, TB, para-pneumonic effusion, empyema, nephrotic
syndrome, malignancy, acute viral hepatitis, heart failure and acute pancreatitis. There was no mortality and long-term
complication in non-malignant cases.
Conclusions: DF outnumbered other causes of pleural effusion in recent times owing to recent Dengue outbreak.
Tubercular effusion was leading cause among cases undergoing pleural tap.
Keywords: Pleural effusion, Dengue, Tuberculosis, Pneumonia, Nephrotic
Department of Pediatrics, Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh
Received: 09 December 2023
Accepted: 05 January 2024
*Correspondence:
Dr. Mohammad Ahad Adnan,
E-mail: ahadnann@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20240085