Snapshot A 56-year-old woman presents to the emergency department due to worsening shortness of breath and cough. Her symptoms began yesterday after receiving peritoneal dialysis. She denies any productive cough, fevers, or chills. Medical history is significant for end-stage renal disease secondary to poorly controlled diabetes mellitus, requiring peritoneal dialysis. Physical exam is notable for a woman with increased work of breathing and decreased breath sounds over the right lower lobe. A chest radiograph is performed, which demonstrates an extensive right pleural effusion. Introduction Definition login to view 1 more bullet Etiology Transudative effusion login to view 5 more bullets Exudative effusion login to view 6 more bullets Pathogenesis login to view 16 more bullets Presentation Symptoms login to view 3 more bullets Physical exam login to view 3 more bullets Imaging Radiography of the chest login to view 2 more bullets Studies Distinguishing transudative and exudative fluid requires the measuring of pleural and serum fluid levels login to view 2 more bullets Thoracentesis with ultrasound guidance login to view 3 more bullets Light criteria login to view 5 more bullets Treatment Depends on the underlying cause login to view 1 more bullet Procedural login to view 6 more bullets Complications Parapneumonic effusion Empyema Prognosis Depends on the cause of the pleural effusion