(2) expectoration of a clear, watery, yellowish fluid
(3) the fluid smells of urine
(4) chemical analysis of the fluid consistent with urine (such as very high creatinine concentration)
(5) variable presence of intrathoracic infection (empyema, lung abscess, etc)
The underlying cause is most often a large perinephric abscess with underlying renal pathology (xanthogranulomatous pyelonephritis, other forms of pyelonephritis, nephrolithiasis, hydronephrosis, renal tuberculosis, gunshot wound, etc)
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