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21st February 2025
A 65-year-old woman is brought to A&E by ambulance with confusion and respiratory distress.
A 65-year-old woman is brought to A&E by ambulance with confusion and respiratory distress. There is no further history available and the woman’s medical records cannot be accessed as she is unable to tell staff her name or any other details. A chest X-ray on admission demonstrates a left-sided pleural effusion which is aspirated. Results of the aspirate and selected blood results are detailed below:
| Pleural fluid | Serum |
| Colour: clear Pleural total protein: 10 g/L pH: 7.6 White cell count: 500/mm³ (<1000/mm³) Glucose: 4.2 mmol/L LDH: 120 U/L |
Glucose: 4.5 mmol/L (4-11 mmol/L) LDH: 590 U/L (240-480 U/L) Total protein: 30 g/L (60-78 g/L) |
Based on these results, which of the following is the most likely underlying cause of the effusion?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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