Last revised by Yuranga Weerakkody on 22 Aug 2023

Pleurodesis is a procedure that involves the administration of an agent into the pleural space to cause adhesion to the chest wall (usually from adhesion between the parietal and the visceral layers of the pleura). Usually an irritative chemical agent (chemical pleurodesis) and rarely microbiological and mechanical methods are used.


It can be used in a number of situation including:

  • development of chronic/recurrent pneumothoraces

  • development of chronic/recurrent pleural effusions


Various agents have been used which include:

  • talc - talc pleurodesis

  • tetracycline class antibiotics

    • minocycline

      • usually around (300 mg)

    • doxycycline

      • tends to requires multiple doses

    • tetracycline

  • Corynebacterium parvum - Corynebacterium parvum pleurodesis

  • mepacrine

  • bleomycin

  • povidone-iodine

  • quinacrine hydrochloride (Atabrine)

Radiographic features
Chest radiography
  • pleural thickening with or without small effusions

  • mediastinal shift to the same side of pleurodesis

  • high attenuation material in the apical or posterior costophrenic angle

  • pleurodesis may not be identifiable in small and post-autologous sclerotic pleurodesis

  • diffuse or nodular (single or multiple) plaque-like pleural thickening

  • high-attenuation sclerosing agent, e.g. talc, or surgical staples in mechanical pleurodesis

  • residual small effusions


Caution must be exercised when interpeting the studies of patients with post-malignant effusion pleurodesis as there may be increased FDG uptake in talc particles.

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