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Table 3-1

Diagnosis Suggested by Pleural Fluid Exam

FindingSuggested diagnosis
Ammonia odor of fluidUrinothorax
Black fluidAspergillus involvement of the pleura
Bloody fluidTrauma, traumatic thoracentesis, pulmonary embolism, or malignancy
Brown fluidRupture of amebic liver abscess into pleural space
Food particles in fluidRupture of esophagus into pleural space
Putrid odor of fluidAnaerobic infection of pleura or empyema
Viscous fluidMalignant mesothelioma due to increased levels of hyaluronic acid
White fluidChylothorax, cholesterol in fluid, or empyema
Yellow-green fluidRheumatoid pleuritis

Source: Adapted from Sahn SA. The pleura. Am Rev Respir Dis 1988;38:184–234.