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December 4, 1967

Bloody Pleural Fluid Following Pulmonary Infarction

JAMA. 1967;202(10):947-949. doi:10.1001/jama.1967.03130230073012

The frequency of morbidity and death from pulmonary embolization represents a cause of increasing concern to the medical community. Symptoms and signs in this disorder are not specific. Accurate diagnosis, accordingly, demands critical appraisal of all findings. Previously accepted observations may need to come under closer scrutiny. For example, it is commonly taught that a bloody or serosanguineous pleural effusion is anticipated following pulmonary infarction. Standard medical texts and reviews on pulmonary embolism1-3 emphasize this finding. Agreement, however, is not universal. At least one author cautions against overemphasizing the frequency of this finding.4 Excessive reliance on the demonstration of blood-tinged pleural fluid in patients with suspected pulmonary infarction may lead to errors of omission. Likewise, errors of commission may occur when sanguineous pleural effusion has another cause.

The findings reported here indicate that physicians in the community of Rochester, NY, are in general agreement with the classical teachings