Causes of Pleural Effusion

Common causes of pleural effusion include:

  • Cardiac failure (heart failure)
  • Tuberculosis
  • Pulmonary embolism (blocked pulmonary artery
  • Metastatic disease (cancer that has spread to the pleurae)
  • Lymphoma (cancer in lymphoid tissue)
  • Trauma

Less common causes include:

  • Liver disease
  • Kidney disease
  • Viral or fungal infections
  • Mesothelioma (tumor originating in the mesothelial cells; malignancy is associated with exposure to asbestos)
  • Adverse drug reaction

Pleural effusion also can occur as a complication after heart surgery.

Hemothorax (pleural effusion with blood in the accumulating fluid) is caused by trauma. Chylothorax, pleural effusion with chyle (lymph and fat) in the accumulating fluid, is caused by neoplastic disease (cancer) and by trauma that impairs the lymphatic draining system.

Some medications may produce drug-induced lupus—a chronic inflammatory syndrome that can manifest as pleurisy, pleural effusion, and other conditions. These drugs include procainimide (antiarrythmia agent), hydralazine (antihypertensive agent), isoniazid (antibiotic), penicillamine (rheumatoid arthritis treatment), and the sulfonamides (antibiotic agents). The syndrome usually goes away after the drug that causes the problem is withdrawn.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 31 May 2000

Last Modified: 01 Oct 2015