Etiology of exudative pleural effusions in adults in North Lebanon

To establish the clinical pattern and etiology of exudative pleural effusions in adults in North Lebanon.

All patients aged 21 years and older who were admitted with exudative pleural effusions to the Husseini Hospital, Tripoli, North Lebanon, between 1997 and 1999 were studied prospectively.

Of 165 patients with exudative pleural effusions, 114 (69.1%) were men and 51 (30.9%) were women. The most frequent cause of exudative pleural effusions was tuberculosis (43.7%), followed by malignancy (32.1%). The majority (88.7%) of malignant pleural effusions were due to lung cancer. Tuberculous effusions were more frequent in the first five decades of life (66.7%) and were the most common type of pleural effusion, accounting for 68.6% of patients younger than 50 years of age. Malignant effusions were more frequent among the older age groups, with 73.6% of patients with malignant effusions being older than 50 years of age. Most types of exudative pleural effusions showed a preference for the right side of the thorax. Of the diagnostic procedures used in the present study, the most useful were histological examination and culture of pleural biopsies.

In North Lebanon, the clinical pattern and etiology of exudative pleural effusions are similar to those in the developing countries; the most frequent cause of pleural exudates is tuberculosis, followed by malignancy, particularly malignancy due to lung cancer.