Intensive Care Medicine (ICM) Practice Exam

What type of pleural effusion is more likely to occur with pneumonia?

1. Transudative

2. Exudative

3. Hemothorax

4. Pneumothorax

The correct answer is: Exudative

Pneumonia can lead to an exudative pleural effusion due to the inflammatory process associated with the infection. When a pneumonia occurs, especially if it is caused by bacteria or a significant inflammatory response, it can result in the accumulation of fluid in the pleural space. This fluid is often rich in proteins and inflammatory cells, which characterizes exudative effusions. Exudative pleural effusions are typically associated with conditions that cause inflammation of the pleura, such as infections, malignancies, or inflammatory diseases. In the case of pneumonia, particularly with conditions like parapneumonic effusion or empyema, the inflammation from the lung infection can lead to the pleural layers becoming permeable, allowing protein-rich fluid to enter the pleural cavity. In contrast, transudative pleural effusions usually result from systemic conditions that alter fluid balance, such as heart failure or cirrhosis, rather than local inflammatory processes. Hemothorax refers to the presence of blood in the pleural space, often due to trauma, while pneumothorax involves the presence of air in the pleural space. Neither of these is primarily related to pneumonia.