A patient has a pleural fluid with 2000 WBCs per mL. Seventy percent of the cells are neutrophils. Which of the following is most likely?
a. Normal fluid
b. Transudate on a patient with a pleural bacterial infection
c. Exudate on a patient with a pleural bacterial infection
d. Exudate on a patient with heart failure
ANS: C
Exudates are formed in response to an infection (viral or bacterial), malignancy, pulmonary embolus, and systemic lupus erythematosus. They generally have a white count greater than 1000/mL. Because the primary cells seen in this fluid are neutrophils, the infection is bacterial.
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