Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea on exertion, non-productive cough, and pleuritic chest pain. Known history of lung adenocarcinoma. Symptoms are worsening over [Number] weeks, associated with orthopnea and decreased exercise tolerance. No fever, chills, or hemoptysis reported.
Clinical Examination Findings
Respiratory exam reveals decreased chest expansion on the affected side, dullness to percussion, and absent tactile fremitus and breath sounds at the lung base. Tracheal deviation away from the affected side may be noted in massive effusions. Patient is tachypneic with accessory muscle use.
Treatment Protocol
Therapeutic thoracentesis performed for symptomatic relief. Pleural fluid sent for cytology, pH, LDH, protein, and glucose analysis. Consider indwelling pleural catheter (IPC) placement or chemical pleurodesis if effusion is recurrent. Continue systemic oncological therapy as per oncology team.