Diagnostic criteria for major diseases related to pleural effusion
| Aetiology | Diagnostic criteria |
| Tuberculous | Identification of Mycobacterium tuberculosis in the sputum, pleural fluid or pleural biopsy specimens,43 either by microscopy or by cultures. In some cases with adequate clinical context, the diagnosis can be made with presence of granuloma in the parietal pleura, good response to anti-tuberculosis treatment, elevated level of pleural fluid adenosine deaminase or positive nucleic acid amplification tests (NAATs).43–45 |
| Congestive heart failure (CHF) | Typical clinical picture of CHF including the Framingham score, medical history and physical examination, the response to diuretic therapy, typical CHF features on chest X-ray, the echocardiographic evidence of left ventricular systolic dysfunction.15 37 46 47 |
| Malignant diseases | Identification of cancer cells in pleural fluid, sputum or bronchoalveolar lavage fluid by cytological examination, ultrasound or thoracoscopy-guided pleural biopsy.5 46 |
| Parapneumonic effusion | Typical clinical and radiological evidences of pneumonia, a positive bacterial culture from pleural fluid or good response to antibiotic therapy.5 46 |
| Pulmonary embolism | Computed tomographic pulmonary angiography.48 |