Causes of pleural fluid eosinophilia

Exudative effusions
Malignancy	Non-small cell lung carcinoma, lymphoma, mesothelioma, metastatic carcinoma, myeloma
Infection	Bacteria (eg, parapneumonic effusion) Fungi (eg, Histoplasma capsulatum, Coccidioides immitis, Cryptococcus) Mycobacteria Parasites (eg, Paragonimus^, Entamoeba, Ascaris, Dracunculus, Dermatobia, Echinococcus, Filaria, Loa, Sparaganum, Strongyloides, Toxocara, Taenia*) Virus
Trauma	Hemothorax Pneumothorax (including catamenial pneumothorax) Thoracic surgery/thoracoscopy Thoracentesis
Drugs	Please refer to the UpToDate table on drug-induced pleural fluid eosinophilia
Toxin	Benign asbestos effusion
Vascular	Pulmonary infarction
Inflammatory	Acute or chronic eosinophilic pneumonia Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) Rheumatoid arthritis Immunoglobulin-4 related disease
Miscellaneous	Hypereosinophilic syndrome
Idiopathic	Etiology may become apparent during follow-up
Transudative effusions
Cirrhosis
Heart failure

This table represents the etiologies associated with pleural fluid eosinophilia (ie, eosinophil count >10% of the total nucleated cell count). In most series, malignancy is the most common etiology, but many are idiopathic.

* Paragonomiasis is the most common parasite infection to cause pleural fluid eosinophilia.

Graphic 82213 Version 5.0

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Causes of pleural fluid eosinophilia