What is the most probable diagnosis?

12 year old female child presented to opd with following clinical picture and below is the X ray obtained



Pleural effusions are caused by the underlying medical problems listed previously, therefore the presence of any of these medical problems are risk factors for the development of pleural effusions. It is important to note, however, that not all individuals with these medical problems will develop pleural effusions.�Congestive heart failure�is the most common cause of�transudative�pleural effusions, while infection (pneumonia) and malignancy are the most common causes of�exudative�pleural effusions. Treatment:-Small transudative effusions may require no treatment, while larger ones and most exudative pleural effusions require treatment. The initial treatment of choice is drainage of the pleural fluid. This is done by thoracentesis (this procedure may be both diagnostic and therapeutic), where a chest tube is inserted into the effusion, and the effusion is drained out. This procedure needs monitoring, and in some instances, the tube may need to remain in the pleural space for a longer period of time for continued drainage. The need for repeated thoracentesis varies from patient to patient depending on the underlying cause, the amount of effusion fluid, the type of effusion (thick, thin,�malignant, or infectious, for example) and if there is recurrence of the pleural effusion. Some pleural effusions (mainly exudative) may require surgery to break up adhesions, while others may require pleurodesis (pleural sclerosis), a procedure whereby different irritant substances or medications are inserted into the pleural space in order to fibrose and�scar�the visceral and pleural surfaces together. This procedure seals the pleural space so that pleural effusions have difficulty reaccumulating. The use of medications for pleural effusions depends on the underlying cause. Antibiotics are used when there is an infectious cause, whereby diuretics such as�furosemide�(Lasix) may be used to slowly help reduce the size of the pleural effusion

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