Review Article
Management of Infectious Processes of the Pleural Space: A Review
Table 2
Different stages in the evolution of an infected pleural effusion with associated pathological changes and pleural fluid findings.
| Phase | Pathology | Pleural fluid findings |
| Exudative | Increased permeability of vascular and visceral pleural membranes VEGF | Nonviscous | Free flowing | Readily drained | Pleural fluid Cx negative |
| Fibrinopurulent | Fibrin deposition on visceral pleura Locules formation IL-8, TNF-α | pH > 7.20 | Glucose within normal ranges | LDH < 3 times ULN | Viscous | More viscous | Pleural fluid cx positive | Typical “complicated” effusion |
| Organizing | Fibroblast entry Pleural peel TGF-β | Thick pus | Very viscous | pH < 7.20 | Glucose < 40 | LDH > 3 times ULN |
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LDH: lactate dehydrogenase. ULN: upper limits of normal. VEGF: vascular endothelial growth factor. IL-8: interleukin 8. TNF-α: tumor necrosis factor-alpha. TGF-β: transforming growth factor-beta.
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