Fluid collection – A Transudate or Exudate

Dear Ask The Doctor: Several weeks ago my father became sick. He went to the doctor with a fever and was checked out and then sent home with an antibiotic. He returned to the doctor 4 days later due to his condition not improving and was then admitted to the hospital. To make a long story short, my dad has never had any kind of heart problems, never had high blood presure, not on any medications, is not over weight, is not a diabetic, does not smoke or drink, and has always been healthy. They found a moderate amount of fluid on the heart and on his right lung. His hemoglobin was low, around 9 something. They have done many test on him,including drawing some of the fluid from his lung and it did not show anything. The doctors have said they are puzzled because they can't find nothing wrong. My question is what could have caused this especially in a healthy man of 68 that has never had prior issues relating to his health to cause this to happen?

Dear Jill: Fluid around the heart collects in the pericardial space and is known as a pericardial effusion. Fluid collects around the lungs in the pleural space and is called a pleural effusion. This fluid can be classified, according to its protein content, into a transudate or exudate. Transudative fluid collections are caused by kidney failure, liver failure, heart failure or nephrotic syndrome. Exudative fluid collections are caused by infections, immunologic responses, lymphatic abnormalities, inflammatory disorders, and some forms of malignancy. It can be difficult to diagnose the cause of the fluid collection especially if it is exudative, because disease in virtually any organ may cause an effusion. I advise consulting your father’s physician for a more detailed explaination.