Teaching Pearls

• Think TB and malignancy in the differential for lymphocytic exudative pleural effusions
• Right sided unilateral exudative effusion in a foreigner/traveler – consider entameoba histolytica, echinococcus, paragonimus
• Pleural Color
  • Pale Yellow –> Transudate
  • Red/Bloody –> Malignancy
  • White –> chylothorax
  • Brown –> long standing bloody effusion, amoebic liver rupture “anchovy paste”
  • Black –> fungal infections
  • yellow-green –> Rheumatoid pleurisy
• Rheumatoid pleurisy and complicated parapneumonic effusions cause the lowest pleural glucose
• The yield of pleural fluid culture is low, pleural biopsy yield for TB is ~90%