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==Introduction==

==Description==

An exudate is a type of effusion that has a high cell count and protein content.  It is often associated with [[Inflammation - Pathology|inflammation]] in the body cavities because changes to the endothelium during this process allow protein-rich fluid to escape from the vasculature and because leucocytes migrate out to the site of disease.  As with any type of inflammation, the exudate may occur in response to a bacterial infection ('''septic''') or it may be sterile ('''non-septic''').  The presence of infection and purulent material in the chest cavity is termed '''pyothorax'''. Commons causes of exudates are:

An exudate is a type of effusion that has a high cell count and protein content.  It is often associated with [[Inflammation - Pathology|inflammation]] in the body cavities because changes to the endothelium during this process allow protein-rich fluid to escape from the vasculature and because leucocytes migrate out to the site of disease.  As with any type of inflammation, the exudate may occur in response to a bacterial infection ('''septic''') or it may be sterile ('''non-septic''').  The presence of infection and purulent material in the chest cavity is termed '''pyothorax'''. Commons causes of exudates are:

Septic exudates

Septic exudates

Exudates may occur in any of the major body cavities.  In the '''abdomen''', there may be signs of abdominal pain (due to the underlying cause of the effusion), an abdominal fluid thrill or a palpable mass.<br>

Exudates may occur in any of the major body cavities.  In the '''abdomen''', there may be signs of abdominal pain (due to the underlying cause of the effusion), an abdominal fluid thrill or a palpable mass.<br>

In the '''chest''', a pleural effusion (including pyothorax) may cause tachypnoea and dyspnoea if severe. Dullness will be evident on thoracic percussion if a pleural effusion has developed and the heart sounds will be muffled on auscultation.<br>

In the '''chest''', a pleural effusion (including pyothorax) may cause tachypnoea and dyspnoea if severe. Dullness will be evident on thoracic percussion if a pleural effusion has developed and the heart sounds will be muffled on auscultation.<br>

'''Pericardial effusions''' may be sufficiently severe to cause '''[[Cardiac Tamponade|cardiac tamponade]]''' and right-sided [[Hear Failure|heart failure]]. The heart sounds will be muffled on auscultation and there may be hepatojugular reflux, a jugular pulse or signs of left-sided forward failure.  The exudate of a chronic septic pericarditis undergoes organisation and replacement with fibrous tissue which bridges the visceral and parietal pericardia.  This results in a '''restrictive pericarditis''' with clinical signs similar to cardiac tamponade.  Infections which penetrate deeply into the cardiac muscle may cause '''[[Myocarditis|myocarditis]]''' with disruptions of the normal conduction pathways and resultant dysryhthmias.<br>

'''Pericardial effusions''' may be sufficiently severe to cause '''[[Cardiac Tamponade|cardiac tamponade]]''' and right-sided [[Heart Failure|heart failure]]. The heart sounds will be muffled on auscultation and there may be hepatojugular reflux, a jugular pulse or signs of left-sided forward failure.  The exudate of a chronic septic pericarditis undergoes organisation and replacement with fibrous tissue which bridges the visceral and parietal pericardia.  This results in a '''restrictive pericarditis''' with clinical signs similar to cardiac tamponade.  Infections which penetrate deeply into the cardiac muscle may cause '''[[Myocarditis|myocarditis]]''' with disruptions of the normal conduction pathways and resultant dysryhthmias.<br>

Septic processes may be accompanied by more general signs of infection, including '''pyrexia''', depression, lethargy and anorexia.  Highly inflammatory exudates may cause severe pain when they damage the parietal pleura or peritoneum.  Affected animals may be reluctant to walk and will stand with a typical 'tucked-up' posture.

Septic processes may be accompanied by more general signs of infection, including '''pyrexia''', depression, lethargy and anorexia.  Highly inflammatory exudates may cause severe pain when they damage the parietal pleura or peritoneum.  Affected animals may be reluctant to walk and will stand with a typical 'tucked-up' posture.

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| Nucleated cells  

| Nucleated cells  

| >3 x 10e9/L, mainly comprising non-degenerate or degenerate [[Neutrophils|neutrophils]], [[Macrophages|macrophages]], [[Lymphocytes|lymphocytes]] or [[Eosinophils|eosinophils]] (with parasites)

| >3 x 10e9/L, mainly comprising non-degenerate or degenerate [[Neutrophils|neutrophils]], [[Macrophages|macrophages]], [[Lymphocytes - Introduction|lymphocytes]] or [[Eosinophils|eosinophils]] (with parasites)

|}

|}

With a septic exudate, the neutrophils are more likely to be present and intracellular (phagocytosed) bacteria may be visible.   

With a septic exudate, the neutrophils are more likely to be present and intracellular (phagocytosed) bacteria may be visible.   

In '''horses''', enterocentesis (or paracentesis) is often performed as part of a [[Colic Diagnosis - Abdominocentesis|colic work-up]].  The following findings are considered to be abnormal and may lend support to a decision to manage the case surgically:

In '''horses''', enterocentesis (or paracentesis) is often performed as part of a [[:Category:Colic Diagnosis in the Horse|colic work-up]].  The following findings are considered to be abnormal and may lend support to a decision to manage the case surgically:

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| Appearance

| Appearance

==Treatment==

==Treatment==

Specific treatment is dependent on the cause of the effusion.  For further details, see the following sections:

Specific treatment is dependent on the cause of the effusion.  For further details, see the following sections:

[[Peritonitis]]

*[[Peritonitis]]

[[Surgical Management of Colic|Treatment of Colic]]

*[[Feline Infectious Peritonitis]]

*[[Feline Infectious Peritonitis]]

*[[Pericarditis]]

*[[Pericarditis]]

*[[Pancreatitis - Dog and Cat|Pancreatitis]]

*[[Pancreatitis|Pancreatitis]]

*[[Rupture of the Oesophagus]]   

*[[Rupture of the Oesophagus]]   

[[Category:Effusions]]

[[Category:Effusions]]

[[Category:To_Do_-_James]]

[[Category:Expert_Review]]

[[Category:To_Do_-_Review]]