Monitoring
Routine monitoring is not required following treatment of most pleural effusions if a clear cause has been found. If the patient again becomes symptomatic, then a chest x-ray is indicated.
In patients with complicated parapneumonic effusions, the pleura are markedly thickened after the infection is treated. These patients should be followed with serial chest x-rays, and if the pleural thickening persists for 6 months and the patient's quality of life is limited by dyspnea, then decortication can be considered.[7]
Patients with undiagnosed pleural effusions should be monitored until the effusion resolves, with a further follow-up period of 2 years in case of potential malignancy. If the effusion increases in size, more aggressive diagnostic procedures such as thoracoscopy should be performed.
Approximately 10% of patients with exudative pleural effusions who undergo complete investigation, including pleural biopsy at thoracoscopy, will have no definitive diagnosis made.[120][121] One study has shown that over a 2-year follow-up period, 8.3% of such patients subsequently had diagnoses of malignant disease.[122]
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