ArticleRespirology case reports2026
Bilateral Bloody Pleural Effusions With Discordant Cellular Patterns: A Case of Concurrent Parapneumonic Effusion and Dressler Syndrome.
Article in Respirology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Bilateral pleural effusions typically suggest systemic aetiologies; however, concurrent distinct localised pathologies are rare. A 73-year-old man presented with fever and cough. Chest imaging revealed pneumonia and bilateral pleural effusions developed during antibiotic treatment. The right effusion was neutrophil-dominant, consistent with parapneumonic effusion, while the left was lymphocyte-dominant, suggesting Dressler syndrome triggered by pneumonia-induced systemic inflammation. Both effusions were bloody, an appearance possibly exacerbated by the concomitant use of a direct oral anticoagulant and aspirin. The left effusion recurred months later but significantly improved following ibuprofen treatment, supporting an immune-mediated aetiology. This case highlights that bilateral effusions can arise from different aetiologies and that pneumonia-induced inflammation may trigger a latent immune response related to prior cardiac surgery.
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