Spontaneous neutrocytic hepatic hydrothorax without ascites.

Pleural effusion occurs infrequently in patients with cirrhosis of the liver, almost always in the presence of clinically obvious ascites. Although the mechanism of fluid transfer into the thorax is controversial, the main factor seems to be the presence of defects in the membranous parts of the diaphragm. This is usually on the right side. Subsequent infection of the pleural fluid is believed to be due to either migration of infected ascitic fluid or by haematogenous spread. The present case report describes a case where a right-sided hepatic hydrothorax without ascites is complicated by bacterial infection. To the authors’ knowledge, this is the first report in the literature.