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Pleural effusion—the accumulation of fluid in the pleural space—can arise from a wide range of conditions. It’s broadly classified into transudative and exudative types based on the underlying mechanism and fluid characteristics. Major Causes of Pleural Effusion Transudative Pleural Effusion This type results from systemic factors that alter hydrostatic or oncotic pressure, leading to fluid leakage without inflammation. Congestive heart failure – the most common cause Cirrhosis with hepatic hydrothorax Nephrotic syndrome – due to hypoalbuminemia Hypoalbuminemia from malnutrition or protein-losing enteropathy Peritoneal dialysis – fluid can migrate into the pleural space Constrictive pericarditis These effusions are typically clear, low in protein, and respond to treatment of the underlying condition. Exudative Pleural Effusion This type is due to local factors like inflammation, infection, or malignancy that increase capillary permeability or lymphatic obstruction. Pneumonia (parapneumonic effusion or empyema) Malignancy (lung, breast, lymphoma, mesothelioma) Tuberculosis Pulmonary embolism Autoimmune diseases (e.g., lupus, rheumatoid arthritis) Pancreatitis Trauma (hemothorax) Esophageal rupture Post-cardiac surgery or radiation therapy Exudative effusions are protein-rich, often cloudy, and require targeted investigation and management #Pleuraleffusion