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. 2009 May 15:247–269. doi: 10.1016/B0-72-168903-5/50015-X

TABLE 10-2.

Characteristics of Selected Types of Effusions

TRANSUDATES EXUDATES
PURE TRANSUDATE MODIFIED TRANSUDATE HEMORRHAGIC EFFUSION NONSEPTIC EXUDATE SEPTIC EXUDATE BILIOUS EFFUSION CHYLOUS EFFUSION
Color Clear Serous Bloody Serosanguineous Purulent, creamy Brown/green Milky/white/pink
Watery Serosanguineous Serosanguineous Dark yellow/green Opalescent
Turbidity Clear Clear to cloudy Opaque Cloudy Cloudy/flocculent Opaque Opaque
Total solids (g/dl) < 2.5 2.5–5.0 >3.0 >3.0 >3.0 >3.0 >2.5
Specific gravity <1.017 1.017–1.025 >1.025 >1.025 >1.025 >1.025 >1.018
Nucleated cells/μ l <1000 500–10,000 >1000 >5000 >5000 >5000 Variable
Differential Mononuclear cells (mesothelial cells, lymphocytes, macrophages)

  • Mesothelial

  • Macrophages

  • Neutrophils (nondegenerate)

  • RBCs (few)

  • Lymphocytes

  • Similar to blood

  • Neutrophils (variable, nondegenerate)

  • Lymphocytes (few)

  • Macrophages (erythrophago- cytosis)

  • Neutrophils (nondegenerate)

  • Macrophages (phagocytized debris)

  • RBCs (variable)

  • Mesothelial (increased in chronic)

  • ± Neoplastic cells

  • Neutrophils (degenerate, phagocytized bacteria)

  • Macrophages (phagocytized bacteria)

  • Mesothelial (variable)

  • RBC (variable)

  • Neutrophils (predominate in acute)

  • Macrophages (phagocytized and free bilirubin crystals: browngranular material)

  • Lymphocytes (few)

  • Lymphocytes (predominate early)

  • Neutrophils (increase in chronic)

  • Mesothelial cells (variable)
Bacteria No No No No May see bacteria ± Pαρɛ
Lipid No No No No No N° High triglycerides (fluid > sera)
Cholesterol (fluid < sera)
Stain positive with Sudan III or oil Red O