Pleural Effusion

[barbie0307]

My son is 23 years old. He started having a lot of pain while breathing or even turning over in bed. He has always been very healthy, very athletic and he doesn't smoke. We took him to the emergency room where they diagnoised him with Pleural Effusion They put him on antibiotics and sent him home. The next day the pulmonary specialist drained the liquid which had collapsed his left lung. They took him off the antibiotics to run a battery of tests and perform an MRI looking for the cause. TB, Heart Disease Blood Clots and Cancer were all rulled out, much to my relief. However, the fluid built back up within a few days and he had surgery. His left lung was collapsed again and enveloped in infection. They did a Pleural Peel and he was in intensive care for two days. He made a complete recovery, however, he is again having symptons of the Pleural Effusion The doctor said there wasn't enough fluid to drain at this time and put him on anti-biotics. From what I understand Pleural Effusion is a sympton of something wrong, if all the obvious has been ruled out, where do we go from here? Does anyone have a similar situation as ours? Also, to make matters worse, my son doesn't have medical insurance since he is just starting his roofing and remodeling company. He has done roofing for several years and recently remodeled a very, very old house. I'm wondering if something he tore out of this old house is the reasons for his infection. Any information or similar stories with resolution would be so greatly appreciated.

[Davy9]

For starters understand that there is always pleura fluid in the pleural cavity. It is there in a small amount to lubricate the lungs as they move within the chest There is a flux of this fluid. It leaves an its replaced with new fluid.

As you note a build up of excess pleural fluid is not normal and is usually a sign of something wrong. But, as you have already experienced that can be caused by any of a number of things and it is not always simple to find out exactly what is happening. Believe it or not pleural effusions can perpetuate themselves with nothing at all wrong. So they treat them. I am a little curious as to why they did the decortication (the lung peel). That is usually done in situations of prior visceral pleural (the pleura lining the lung) scarring leading to a capture syndrome (which does perpetuate effusions). I've not seen that done in young people without much lung disease history. It could be a newer and better approach.

They can introduce agents that will cause the 2 pleura linings to adhere. That sometimes ends chronic effusions but it can also result in them just loculating in pockets.

The good news is that they have eliminated the more dire causes. The work on the older home may have resulted in a simple case of pleurisy from airborne irritants or not. The scarier part about older homes is the prospect of asbestos. They almost always test for the presence of hazardous asbestos and have hazmat removal of the material. Asbestos does not typically result in acute processes.

I assume they have studied the fluid material removed and you know the results. Fluids called transudates are usually non infectious while exudates are almost always infectious. If they were infectious they might have been able to identify the organism causing the infection. It can be a tough place to get healed up back to normal. You seem to b asking the right questions and getting the correct treatments.

[barbie0307]

Thank you so much for your input. At the time of the surgery I had read about the talc procedure. The doctor was adament that was not an option in someone as young as my son as it adhers the lung to the cavatiy and is done in much older patients that have an existing life threatning disease. It's good to hear that this can be caused without anything wrong at all, probably not what most patients would like to hear, but the alternatives are not good. We are keeping the hope that this will not be a lifelong situation he must deal with. Again, thank you for answering my post.