Pleural effusion: presentation, causes and treatment outcome in a resource limited area, Ethiopia

Abstract

Back ground: Pleural effusion is a common clinical problem with different causes. Objective: To demonstrate clinical features and outcome of pleural effusion. Methods: Prospective descriptive study was conducted involving 110 patients with pleural effusion admitted to a resource limited hospital in Ethiopia. Results: Males and females were almost equally represented. Cough, fever and weight loss were prominent presenting symptoms accounting 90, 77.3 and 77.3 percent respectively. Right side effusion was the common presentation 50 (45.5%). Forty (37.4%) patients had HIV infection among 107 tested. Tuberculosis was the commonest cause 78 (70.9%) followed by parapneumonic effusion 36 (32.7%) and empyema 27 (24.5%). Malignant pleural effusion was detected only in one patient. Eighty one (73.6%) improved from their illness and 7 (6.4%) died. Lympocytic pleural effusion found to be associated with tuberculosis (OR = 3.942 (1.527 - 10.179), P = 0.005. There were no associations between HIV infection, anemia, elevated ESR and side of pleural effusion with tuberculosis. Conclusion: Tuberculosis was the leading cause of pleural effusion in our setup even though etiologic diagnosis was difficult. Strengthening the laboratory and pathology services in the area is strongly recommended.