Pleural effusions in collection of fluid in the pleural space (the area between the lungs and chest wall).

What causes pleural effusion in children?
The most common cause of pleural effusion in children is pneumonia and these effusions are called as parapneumonic effusions. Sometimes the effusion becomes converted into pus and called as a empyema. The second common cause of pleural effusion in India is tuberculosis. The other not so common causes of pleural effusion are cardiac problems, nephrotic syndrome, lymphomas, ewings sarcoma etc.

What are the symptoms of pleural effusion in children?
The symptoms of pleural effusion are usually fast breathing and difficulty in breathing. There can be a associated chest pain. Fever, cough and weight loss can also be symptoms of pleural effusion in children.

How do we diagnose the cause of pleural effusion in children?
If the child’s symptoms and examination findings are suggestive of fluid in the pleural cavity further investigations are warranted. The two most important investigations are an Xray Chest and ultrasound examination.

If the presence of pleural fluid is confirmed a sample of the pleural fluid for detailed analysis is needed. In this procedure called thoracocentesis, a small needle and injection is used under local anesthesia to obtained 5-10 ml pleural fluid. The pleural fluid obtained is sent for detailed analysis to the laboratory for presence of cells, micro-organism (bacteria, tuberculosis, etc), proteins and sugar.

How do we treat pleural effusion in children?
The treatment of pleural effusion depends on the cause of pleural effusion. In case of pneumonias antibiotics are required for 7-10 days. Children with tuberculosis require anti-tubercular medicines. If the effusion is large then it needs to be removed either with a syringe and needle or occasionally a chest tube need to be inserted.