2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43
Symptoms and causes of pleurisy
What is pleurisy?
Pleurisy is inflammation of the pleura with the formation of fibrous plaque on its surface or effusion inside it. It appears as an accompanying pathology or as a result of various diseases. Pleurisy is an independent disease (primary pleurisy), but most often it is the consequences of acute and chronic inflammatory processes in the lungs (secondary pleurisy). Divided into dry, otherwise called fibrinous, and effusion (serous, serous-fibrinous, purulent, hemorrhagic) pleurisy. Also, pleurisy is of bacterial, viral and allergic etiology. Over the years, pleurisy with a nonspecific etiology is most common. Pleurisy symptomsSymptoms also differ depending on the causes of pleurisy. With dry pleurisy, chest pain is observed, aggravated by inhalation, when bending back in the opposite direction. The pain intensifies and then subsides if you lie on your side. There may be pain radiating to the neck and muscles of the upper body, frequent breathing is observed. With purulent pleurisy, chest pain occurs, aggravated by breathing, high body temperature. Often chills, shortness of breath, sweating, and severe tachycardia occur with this type of pleurisy. Various studies can detect the accumulation of fluid in the pleural cavity. If you do not start treatment in a timely manner, the patient suffers from weakness, intoxication, the person loses weight greatly, the skin becomes brownish-yellow. Metapneumatic purulent pleurisy is expressed by chest pain, shortness of breath. In order to accurately establish the diagnosis, it is necessary to make an X-ray examination of the lungs. The course of treatment depends on whether the pleurisy is infectious, caused by pathological bacteria, or aseptic, which develops with lung cancer. Pleurisy reasonsThe reasons for the development of pleurisy can be colds. Hypothermia, fatigue, poor nutrition, high sensitivity to any drug can serve as a push. It appears as an accompanying pathology or as a result of various diseases. However, sometimes it manifests itself before the onset of symptoms that cause pathology. Very often, the cause of pleurisy is systemic pathologies of the connective tissue (rheumatism, systemic lupus erythematosus, etc.), neoplasms, thromboembolism and pulmonary thrombosis. For the most part, the mechanism of pleurisy is allergic. An important role in the pathogenesis of blastomatous pleurisy is played by the blocking of lymph nodes, lymphatic and venous vessels by tumor metastases; when a tumor penetrates from nearby organs, the destruction of serous integuments. |
Purulent pleurisy
Purulent pleurisy is caused by such microorganisms as pathogenic staphylococci, pneumococci, streptococci. In rare cases, these are Proteus, Escherichia sticks.
As a rule, purulent pleurisy develops after exposure to one type of microorganism, but it happens that the disease is caused by a whole association of microbes.
The development of the disease. The causative agent enters the body by contact from subpleurally localized pneumonic foci of the lungs, purulent inflammation. In a hematogenous way, the pathogen penetrates from various foci of infection (with osteomyelitis, inflammation of the middle ear, phlegmon of the navel, purulent appendicitis, inflammation of the abdominal cavity), rarely observed primary purulent pleurisy occurs.
With purulent pleurisy, large fibrinous deposits are observed on the pleura, covered with pus, reaching a considerable thickness. On the surface of the pleura, there are areas of small hemorrhages, a sharp overflow of blood vessels.
Symptoms of purulent pleurisy. The course of the disease differs depending on age. In infants of the first three months of life, purulent pleurisy is very difficult to recognize, since it is masked by the general symptoms characteristic of umbilical sepsis, pneumonia caused by staphylococci. From the side of the disease, the chest becomes convex. There is also a drooping of the shoulder, insufficient mobility of the hand. In older children, the standard symptoms of total pleurisy are observed. You can also note a dry cough with phlegm, sometimes even with pus - when a pleural abscess breaks out into the bronchi.
Exudative pleurisy
In the initial stage of exudative pleurisy, pain in the side is observed, a decrease in the amplitude of respiratory movements of the sore side of the chest, a characteristic sound of pleural friction. A dry, painful cough of reflex origin often occurs. As the effusion accumulates, the pain in the side disappears, a feeling of heaviness appears, increasing shortness of breath, cyanosis of moderate intensity, slight swelling of the affected side, smoothing of the intercostal space.
Percussion over the exudate listens to a dull noise; voice tremor and bronchophonia are less than normal, the air does not pass or is more weakened. Tympanic shade of percussion noise, bronchial respiration and fine bubbling rales. During percussion and X-ray examination, a specific outline of the upper region of the effusion may be revealed.
A strong effusion promotes the movement of the mediastinum into the healthy half and severe defects in the function of external respiration due to a failure of the mechanics of respiration: the depth of breathing decreases, it becomes very frequent; with the help of functional diagnostics, it is possible to calculate the drop in external respiration indicators (vital volume of the lungs, ventilation reserves, etc.). Malfunctions in the work of the cardiovascular system are manifested: a decrease in the stroke and minute volume of the heart due to a decrease in the effect of drawing blood into the central veins due to ventilation defects, displacement of the heart and large vessels with abundant pleural effusions. Compensatory tachycardia increases, blood pressure gradually decreases.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
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