Pleurisy: symptoms and treatment, medications and folk remedies. Pleurisy of the lungs: what is it, how to treat folk remedies? Causes, symptoms and treatment of pleurisy of the lungs. What is dangerous pleurisy of the lungs? Signs of pleurisy of the lungs in adults
![Pleurisy: symptoms and treatment, medications and folk remedies. Pleurisy of the lungs: what is it, how to treat folk remedies? Causes, symptoms and treatment of pleurisy of the lungs. What is dangerous pleurisy of the lungs? Signs of pleurisy of the lungs in adults](https://i1.wp.com/pnevmonet.ru/wp-content/uploads/2017/10/prpl.jpg)
Inflammation of the pleural membrane, which is accompanied by the accumulation of fluid and the presence of fibrous plaque, is called pleurisy. The disease can act as a concomitant pathology, or develop as a result of any diseases. The disease is most severe in children and the elderly.
Disease classification
Depending on the cause of the occurrence, pathology can be classified as follows:- Primary. This type of disease is independent, develop independently of other diseases.
- Secondary. Acts as a complication of pulmonary inflammatory processes. Moreover, the latter can be acute or chronic.
- Dry pleurisy (otherwise - fibrinous).
- Exudative form (purulent, serous, hemorrhagic, serous-fibrinous).
- Diffuse (fluid moves throughout the pleural cavity).
- Encapsulated (effusion accumulates in any area).
Sometimes pathology indicates the course of systemic ailments. Pleurisy of the lungs usually develops with oncology or tuberculosis. However, specialists often begin the treatment of inflammation directly, forgetting about the root cause of its occurrence. The inflammatory process can manifest itself in both a child and an adult. Many remain undetected.
What causes the disease
Speaking about the causes of the disease, it is necessary to understand: what it is and what are the symptoms of the disease.
Pleurisy is one of the diseases of the respiratory system. The pathology is characterized by damage to the pulmonary and parietal pleura. The latter is a membrane covering the right and left lungs, and lining the chest.
The effusion form of the disease is accompanied by the accumulation of any exudate in the pleural cavity (between the sheets). There may be collected pus, blood, inflammatory fluid.
The conditional classification of the cause of the disease is as follows:
- Infectious.
- Inflammatory (aseptic).
- Regular overwork, stressful situations.
- Hypothermia.
- Food containing a low amount of useful elements.
- Insufficient motor activity.
- Having an allergy to medications.
Hypothermia increases the risk of developing
If we talk about the infectious nature of pleurisy, then its causes may be:
- Syphilis.
- Tuberculosis.
- Bacterial infection (for example, staphylococcus aureus).
- Candidiasis (or any other fungal infection).
- Tularemia.
- Operational interventions.
- Any injury to the chest.
- Spread of metastases to the pleura (lung cancer, etc.).
- Lung infarction, systemic vasculitis, etc.
- Pulmonary embolism.
- Tumor-like formations of pleural sheets.
The development of pleurisy occurs at different speeds. The disease can persist for quite a long time..
The approximate classification is as follows:
- Acute course of the disease (up to 14-28 days).
- Subacute (from 30 days to six months).
- Chronic form (more than 6 months).
The ways of infection of the pleural cavity with microorganisms are different. Contact infection involves infection through the lymphatic fluid or blood. Direct contact with bacteria is possible with surgical intervention, or with injuries and injuries.
The question of whether pleurisy is contagious often worries relatives of the patient. An unequivocal answer can be given based on the cause of the lesion. Pleurisy developed as a result of an injury is not transmitted to others. If the root cause of the disease is viral, the disease may well be transmitted, although the likelihood of infection is low.
Dry pleurisy
It differs in the formation of fibrin on the surface of the pleura. There is no effusion in the pleural cavity. Usually this form of the disease occurs somewhat earlier than exudative.
Usually the disease is concomitant with diseases such as:
- Rheumatism.
- Collagenosis.
- Malignant tumors.
- Most pathologies of the intrathoracic lymph nodes and lower respiratory tract.
- Some viruses.
As an independent disease, dry pleurisy develops infrequently.
Tuberculous pleurisy
According to medical statistics, an increasing number of patients suffer from this type of disease.
Pathology can be any of three forms:
- Fibrous.
- Purulent.
- Exudative.
- Perifocal.
- Tuberculosis of the pleura.
- Allergic.
Approximately half of the cases of dry pleurisy is a signal indicating the presence of a latent form of tuberculosis. Tuberculosis of the pleura is extremely rare. More often, lymph nodes or lungs are affected, and fibrous pleurisy in this case plays the role of a concomitant pathology.
Purulent pleurisy
Certain groups of microbes are capable of causing purulent pleurisy of the lung, namely:- Streptococci.
- Pneumococcus.
- Pathogenic staphylococci.
Other types of sticks are much less common. Usually one group of microbes contributes to the development of the disease, but sometimes several varieties act at once.
The symptoms of this form of the disease, as well as the clinical picture, vary depending on the age of the patient. In children of the first year of life (usually up to 3 months), purulent pleurisy often proceeds similarly to umbilical sepsis or pneumonia, the causative agent of which is staphylococci.
Visually, you can diagnose the bulge of the chest. There is a partial omission of the shoulder, and the arm becomes inactive. The disease in older children is characterized by symptoms of total inflammation of the pleura. The patient may be disturbed by a dry cough with sputum or purulent discharge.
Encapsulated pleurisy
One of the most severe forms of the disease is encysted pleurisy of the lung. Pathology develops against the background of prolonged inflammation in the pleura and lungs. Because of this, a large number of adhesions occur, and the exudate is separated from the pleural cavity. The pathology is characterized by fusion of the pleura, which leads to the accumulation of effusion in one area.
Exudative pleurisy
Its main difference is the accumulation of fluid in the pleural cavity.
Stagnation of effusion occurs due to:
- Injuries to the thoracic region, which is accompanied by bleeding.
- Hemorrhages.
- Outpouring of lymphatic fluid.
- Serous-fibrinous.
- Mixed.
- Hemorrhagic.
- Chile.
The origin of the effusion is usually difficult to establish. The accumulated fluid is fraught with breathing problems because it restricts the movement of the lungs.
Symptoms of the problem
The inflammatory process can proceed with the formation of exudate or without it. Depending on this, the symptoms of pleurisy vary.
The dry form of pathology corresponds to such signs as:
- Soreness of a stitching character in the region of the thoracic region. It is especially pronounced when coughing, sudden movements, deep breaths.
- The need for placement on the affected side.
- Breathing is superficial, and the affected half of the sternum visually lags behind the healthy one.
- When listening, you can determine weaker breathing in the area of fibrin formation, as well as a pleural friction rub.
- Excessive sweating, chills, fever.
- Pain syndrome of dull nature in the damaged area.
- Prolonged cough without expectoration.
- A pronounced lag of the diseased sternum in breathing.
- Shortness of breath, heaviness, intercostal spaces swell.
- Increased body temperature, weakness and fatigue, excessive chills.
The clinical picture of purulent pleurisy in both adults and children is somewhat worse.
The disease is accompanied by such signs:
- Increase in body temperature.
- Increased pain in the chest.
- Trembling and aches.
- Cardiopalmus.
- The skin becomes earthy.
- Loss of body weight.
When pleurisy from an acute form flows into a chronic one, pleural adhesions begin to appear in the damaged lung. They prevent the lung from expanding normally, exacerbating existing breathing problems.
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Possible Complications
Timely treatment of pleurisy of the lungs will help prevent many consequences:- The formation of adhesions in the pleural cavity.
- Obliteration of interlobar fissures.
- Adhesive pleurisy.
- Healing of the pleural cavities.
- Increase in the thickness of the pleura.
- The occurrence of pleurosclerosis.
- Empyema (accumulation of purulent discharge).
- Respiratory failure.
- Decreased diaphragm movement.
The presence or absence of complications is directly related to the cause of the pathology. Knowing how dangerous pleurisy of the lungs is, you should not postpone going to a specialist.
Problem Identification
Only a competent doctor can decide how to treat pleurisy of the lungs. The selection of therapy is based on the results of the examination of the patient. To diagnose pathology, certain examinations are carried out in the clinic.
Here is their list:
- Visual inspection, history taking.
- Clinical examination of the patient.
- Carrying out radiography.
- Microbiological research.
- Blood sampling for analysis.
- Examination of the pleural fluid.
Moreover, the diagnosis is usually not difficult. It is more problematic to determine the reasons due to which the pleura became inflamed and exudate began to accumulate.
Treatment of the disease
Having identified pleurisy of the lungs, its symptoms, the doctor prescribes a comprehensive treatment. The main direction is the elimination of the root cause of the inflammatory process.
Please note: only dry pleurisy can be treated at home. Patients with any other form of the disease should be in a therapeutic hospital. If the patient is diagnosed with pleural empyema, he should be placed in the surgical department.
To cure dry pleurisy, perform the following steps:
- Taking painkillers to relieve pain. If tablet preparations do not bring the desired effect, it is permissible to replace them with narcotic painkillers. The latter is possible only on inpatient treatment.
- The use of warm compresses based on alcohol, camphor. The result is the use of mustard plasters and iodine mesh.
- Getting rid of cough by taking specialized drugs.
- Since pleurisy usually occurs against the background of tuberculosis, the root cause of the disease should be eliminated. Patients with the tuberculosis form of the disease are treated in the appropriate dispensary.
With the development of the exudative form of the disease, a puncture is often performed. For one procedure, it is allowed to eliminate a maximum of 1.5 liters of inflammatory fluid. Otherwise, cardiac complications cannot be avoided. The purulent form of the disease is characterized by washing the cavity with antiseptic solutions.
If the stage of the disease is chronic, a pleurectomy may be performed. Removal of a small part of the pleura is acceptable in both adults and children. The procedure helps to prevent possible relapses of the pathology. As soon as the exudate resolves, the patient should do physiotherapy exercises, therapeutic and breathing exercises.
Folk methods
Elimination of the disease with folk remedies should be carried out in conjunction with taking medications. Please note: it is unacceptable to neglect the hospital when a kind of pathology requires being in it. If you adhere to the therapy of folk remedies at home, you can significantly aggravate the disease.
With pleurisy of the lungs, treatment with folk methods is based on the use of various compresses, as well as the intake of decoctions and tinctures.
Here are some recipes:
- At home, you can get fresh beet juice, then mix it with honey in a ratio of 100 g / 2 tbsp. l. respectively. The mixture should be taken twice a day, after eating. It is not subject to storage, so each time it is necessary to prepare anew.
- From pleurisy, an infusion of mint, cudweed and coltsfoot can help. Take 1 tbsp. 3 times a day.
- Infuse plantain at home. For 0.5 liters of boiling water, take about 2 tbsp. l. dried leaf. Strain the resulting infusion and take warm 100 ml 4 times a day.
- Therapy with folk remedies involves the use of onion juice with honey. Mix equal proportions of the components and take 1 tbsp. l. twice a day.
To cure pleurisy in adults and children, you can use not only drug therapy. Wisely selected folk remedies will also bring invaluable benefits.
Pleurisy is a disease that is characterized by inflammation of the two layers of the pleura - the pulmonary and parietal. In a healthy person, the lungs are covered with a thin film consisting of two layers, between which there is a negligible amount of fluid. Pleurisy is characterized by a significant formation of effusion (exudate) between the membranes. Fluid can accumulate if it is not excreted by the body (exudative pleurisy), or it can leave plaque on the walls of the pleura (fibrous pleurisy). In any case, this is a serious disease that rarely goes away on its own and without complications. Treatment of pleurisy of the lungs is successful if the patient was diagnosed in time and treatment started.
Pleurisy of the lungs is an inflammation of the two layers of the pleura.
Causes of the disease
Pleurisy can be of infectious and non-infectious origin, depending on its etiology, the causes and methods of treatment differ. Infectious pleurisy occurs as a result of inflammation pathogens entering the pleura directly from the lungs and bronchi or internal organs of the peritoneum.
The causative agents include:
- fungi;
- anaerobic bacteria;
- legionella;
- viruses;
- tubercle bacilli;
- pneumococci.
Infectious pleurisy is always a consequence of a neglected infectious disease. It is also sometimes found in patients with typhus and infected with echinococcus and mycoplasmosis.
Non-infectious pleurisy occurs as a result of unsuccessful surgical operations, lung injury, an allergic reaction to certain substances, and may also be a concomitant symptom of the following diseases:
- sarcoidosis;
- pulmonary embolism;
- pleural metholioma;
- ovarian tumor, etc.
Also, non-infectious pleurisy can be observed after or electric shock. Only a doctor can determine the exact cause of the onset of the disease. Treatment is prescribed depending on the type of disease.
Effusive pleurisy and its symptoms
This type of pleurisy is also called exudative, since a significant amount of fluid accumulates in the pleura. The disease affects only a localized part of the pleura, so the patient feels pain in a specific area on the right or left side. In this case, dry, shortness of breath and heaviness in the region of the left or right lung are often observed. The fluid compresses the lung, it swells, as a result of which the patient cannot fully breathe and feel very ill. Pain usually subsides if the patient lies on his side.
The following symptoms are also observed:
- general weakness;
- elevated temperature (usually subfebrile, but sometimes febrile is also observed);
- loss of appetite up to the complete refusal of food, nausea;
- swelling of the extremities, neck and face.
![](https://i1.wp.com/simptom-lechenie.ru/image/plevrit_legkih_02.jpg)
Fibrous pleurisy and its symptoms
This disease does not lead to the accumulation of fluid in the pleura, since all of it is excreted from the body, but its dry residue remains on the pleura, which leads to increased inflammation. Such a disease is always an “addition” to inflammatory processes in the lungs, so the underlying disease must be treated first. It can also be difficult to determine the symptoms of fibrous pleurisy, as they are “lost” against the background or.
But there are some main features:
- the patient has a dry, accompanied by a sharp pain in the side or back;
- it is impossible to take a deep breath, when trying, severe pain is felt;
- breathing is difficult, shallow;
- constant tension of the abdominal muscles.
Running fibrous pleurisy threatens the formation of irreversible adhesions in the lungs, so treatment should be immediate.
Purulent pleurisy and its symptoms
This form of the disease is characterized by the accumulation of pus in the pleura and always proceeds in an acute form. Has the following features:
- temperature rise to febrile;
- increase and due to pus in the pleura on the heart;
- dry cough;
- constant pain and pressure in the chest;
- labored breathing.
Purulent pleurisy is treated exclusively in a hospital.
![](https://i2.wp.com/simptom-lechenie.ru/image/plevrit_legkih_04.jpg)
Tuberculous pleurisy and its symptoms
This disease is often a companion of the lungs and manifests itself in the form of empyema, perfocal or allergic pleurisy. Sometimes it is possible to identify only because of inflammation of the pleura, since it can be hidden. Tuberculous pleurisy most often has no obvious symptoms.
It is characterized by:
- a slight increase in temperature;
- general fatigue, weakness, depression;
- shortness of breath and difficulty breathing;
- cough;
- mild chest pain.
This type of pleurisy can be chronic and last for years, pain may disappear for a while, but that does not mean a cure. Difficult to diagnose.
![](https://i2.wp.com/simptom-lechenie.ru/image/plevrit_legkih_05.jpg)
Different forms of the disease have different symptoms, but in any case, a person will feel pain in the chest, side or back, it will be difficult for him to breathe deeply. In advanced cases, the size of the chest increases, it seems swollen, the veins in the neck swell, and the face often swells. A change in skin color on the chest or face can also be a sign of pleural inflammation. Often, when squeezing the lung, it is observed, which is often confused with rheumatic. That is why it is important not to self-medicate, but to immediately consult a doctor if one of the above symptoms has been observed for more than two weeks.
Diagnosis of pleurisy
The therapist establishes the diagnosis on the basis of listening to the patient's breathing and feeling his chest for an increase in the size of the lungs. Also, the patient needs to take a blood and urine test to establish the presence of persistent inflammation in the body. An x-ray and ultrasound examination of the lungs help to make an accurate diagnosis and assess the size of the lesion.
After the patient has been diagnosed, fluid is taken from the pleura to determine what fluid accumulates in it. Most often it is exudate or pus, in rare cases - blood. It is noteworthy that the purulent form of the disease is more common in children.
If there is a suspicion of oncology or the patient is diagnosed with lung cancer, a pleura is performed, but such cases are extremely rare.
Important! Although pleurisy is a secondary disease, it is contagious. This applies exclusively to the infectious form of the disease. Therefore, the patient should avoid contact with others and wear a gauze bandage, which must be replaced every few hours. The disease is transmitted by airborne droplets. Tuberculous pleurisy is especially dangerous, as it is difficult to diagnose, weakly manifests itself and often has a chronic character.
Pleurisy treatment
After establishing the diagnosis, the patient is hospitalized and prescribed anti-inflammatory drugs, antibiotics. Most medications are aimed at relieving symptoms and inflammation, while the main forces are aimed at treating the disease, the consequence of which was pleurisy.
In addition to medicines, patients are prescribed a special diet, and after the condition improves, physiotherapy procedures that help the respiratory system restore its function. The patient needs to give up complex, hard to digest food, so as not to create an additional load on the stomach. The basis of nutrition should be food with a high content of vitamins - cereals, vegetables, fruits, herbs, broths. It is also worth avoiding stressful situations and unrest, sometimes it is necessary to take sedatives.
![](https://i0.wp.com/simptom-lechenie.ru/image/plevrit_legkih_06.jpg)
Drug treatment depends on the cause of pleurisy, namely:
- if the disease is caused or acute, then it must be treated with antibiotics;
- pleurisy caused by other chronic inflammatory processes and not accompanied by febrile temperature is treated with non-steroidal anti-inflammatory drugs;
- treatment of tuberculous pleurisy is carried out with the help of special medicines and lasts up to six months.
In all cases, patients are prescribed expectorants, painkillers and diuretics. If the liquid presses on the heart, then the attending physician prescribes means to maintain the heart muscle and blood vessels.
If the above therapy does not lead to a decrease in exudate in the lung, or its critical volume is high (sometimes it can reach several liters), then the patient is pumped out. To do this, the doctor inserts a needle into the inflamed area and pumps out the effusion or pus, after which he injects a small amount of anti-inflammatory drugs into the interpleural area. In rare cases, and with chronic tuberculous pleurisy, the patient needs regular drainage, sometimes it is necessary to excise part of the lung.
Treatment with folk remedies
Folk remedies cannot cure the disease on their own, but they will be a good addition to medications. Patients are shown a pulmonary collection that promotes expectoration and restoration of the alveoli, as well as a decoction of herbs such as wild rosemary, licorice root, plantain leaves. Patients are advised to drink fresh beet juice and regularly eat boiled beets. You can reduce swelling and remove excess fluid from the body with a decoction of horsetail and chamomile. You can take these funds only after consulting a doctor and only if there are no contraindications.
Important! If a child is ill with pleurisy, then it is impossible to treat him with folk remedies. His lung capacity is still very small, and even a slight accumulation of fluid can lead to a sharp deterioration in the condition and suffocation..
![](https://i2.wp.com/simptom-lechenie.ru/image/plevrit_legkih_08.jpg)
Recovery after pleurisy and disease prevention
After discharge from the hospital, patients need to perform breathing exercises prescribed by a doctor to restore full lung activity. Showing moderate physical activity, long walks in the fresh air, yoga is very useful. It is especially useful for convalescents to be in a coniferous forest.
Strengthening, taking care of your health and giving up bad habits, especially smoking, will help to avoid the disease. In the cold season, it is necessary to regularly moisten the air dried up by heating devices and ventilate the room.
This article is posted solely for the general educational purposes of visitors and is not scientific material, universal instructions or professional medical advice, and does not replace a doctor's appointment. For diagnosis and treatment, contact only qualified doctors.
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I am a general practitioner and general practitioner. My competence includes issues of early diagnosis of patients and treatment of many diseases of the gastrointestinal tract, lungs and respiratory tract, liver, kidneys, cardiovascular and genitourinary systems, skin diseases, metabolic disorders, etc. 15 years of experience as a general practitioner in polyclinics Moscow, 5 of which worked in one hospital in St. Petersburg .. I will be happy to answer questions from readers of my blog.
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Update: December 2018
Each lung is enclosed in a two-layer bag (pleura), between the sheets of which, as a result of various diseases, blood, edematous or inflammatory fluid can accumulate. This condition in medicine is called pleurisy, which is extremely rare in the form of an independent disease, usually this process is a complication of such diseases and conditions as:
- pulmonary tuberculosis
- connective tissue diseases - autoimmune (rheumatism, systemic lupus erythematosus)
- allergic reactions (pleurisy)
- hemorrhage in injuries and operations on the chest
- acute bacterial pneumonia (usually pneumococcal)
- cardiovascular, renal,
- oncological processes, leukemia
- infectious diseases (brucellosis, syphilis)
- fungal diseases of the lungs
- dystrophy from prolonged starvation
- with acute pancreatitis, the development of enzymatic pleurisy is possible
Each of these conditions reduces the body's defenses, disrupts the normal course of metabolic processes, changes the composition of blood and lymph. In the pleura there is a fairly developed capillary network of lymphatic and blood vessels, which are the source of fibrin or fluid in its cavity.
However, the most common causes of fluid accumulation in the pleural cavity and the development of pleurisy today are tuberculosis and oncology. An independent and very dangerous disease is pleural empyema - purulent pleurisy. Our article is about pleurisy, symptoms and treatment of this insidious disease.
Types of pleurisy
Dry pleurisy
Symptoms of dry pleurisy
Pleurisy has a number of specific symptoms. At the same time, the clinic of dry pleurisy differs significantly from pleurisy with effusion. The clinical picture is complemented by the symptoms of the underlying disease.
The onset of the disease is sudden, patients can accurately indicate the time of onset of the disease. The infection process may be accompanied by high fever. Fibrinous pleurisy is characterized by a sharp pain syndrome on the affected side of the lung. Breathing is superficial, a painful cough appears, all this is accompanied by severe pain that arises from the contact of the inflamed pleura. Pain is aggravated by tilting the body in the opposite direction, with a deep breath or coughing.
The patient tries to lie on a healthy side, which slightly alleviates his suffering. With the localization of the inflammatory process near the diaphragm, pain can occur in the upper abdomen, in the heart, in the neck, which creates the basis for erroneous diagnoses.
Diagnostics
On examination, the diseased half of the chest lags behind in the act of breathing, this can be seen from the movement of the shoulder blades. When listening to the lungs, a very characteristic sound of pleural friction is determined.
Radiography in acute dry pleurisy does not provide sufficient information. Laboratory tests will characterize the underlying disease.
Treatment of dry pleurisy
- To stop the pain syndrome, painkillers are prescribed analgin, ketanov (see the list of NSAIDs in the article), tramadol, if these drugs are ineffective, in a hospital, narcotic painkillers may be administered.
- Effective warming semi-alcohol or camphor compresses, iodine mesh.
- Cough suppressants are prescribed - sinekod, codelac, libexin (see).
- Since the root cause is most often tuberculosis, after confirming the diagnosis of tuberculous pleurisy, a specific treatment is carried out in the anti-tuberculosis dispensary.
For reference:
- According to WHO, the mortality rate from tuberculosis and the number of patients with tuberculosis (including tuberculous pleurisy) in Russia are 8 times higher than in European countries.
- Prisoners ill with tuberculosis, when leaving prison, as a rule, do not go to doctors and are not registered, infecting 10-20 people a year.
- Every year in Russia 25,000 people die of tuberculosis, 120,000 people fall ill.
- The worst thing is that every 10 patients have multiple drug resistance, that is, a practically incurable form of pulmonary tuberculosis and its extrapulmonary forms (kidneys, joints, spine, genitals, eyes).
Exudative pleurisy and hydrothorax
Symptoms of exudative pleurisy
Unlike fibrous pleurisy, pain in pleurisy with various types of effusion is not a leading symptom, with the exception of chest injuries, so signs of fluid accumulation appear only a few days after the onset of the disease.
Exudative pleurisy begins gradually, the symptoms grow slowly, the person complains of headache, fever, weakness, a feeling of heaviness in the affected side of the chest, with gradually increasing shortness of breath, which worries the patient even at rest (see).
Shortness of breath is caused by a decrease in lung volume, due to compression of their enlarged pleural cavity. The pulse quickens, the face turns pale, the nasolabial triangle takes on a bluish tint, the veins of the neck swell. In the place of accumulation of effusion, intercostal spaces may swell. There is a lag of the affected half during breathing.
In severe conditions caused by insufficiency of the heart, liver, kidneys, the process can develop symmetrically, pleurisy is noted on both sides. Then there will be no bright symptoms characteristic of pleurisy, although the general condition of the patient will worsen.
Tuberculosis remains the most common cause of exudative pleurisy in adults, and in 70% of cases it begins as lobar pneumonia, with 39C fever, pain, general weakness, and chills.
Diagnostics
The leading criterion will be radiography, radiological signs of pleurisy or hydrothorax are quite eloquent. On auscultation of the lungs, in contrast to dry pleurisy, the affected side of the chest is "silent". Laboratory indicators will correspond to the underlying disease. Only with hemorrhagic pleurisy can there be signs of anemia (anemia).
Treatment
Exudative pleurisy is treated in a hospital. In the edematous form of the underlying disease, an unloading diet is prescribed that restricts fluid and salt. With purulent pleurisy, antibiotic therapy (broad-spectrum antibiotics), NSAIDs, painkillers and antihistamines are required, which reduce swelling and have an antiallergic effect (see).
If the volume of the effusion is large enough, resulting in marked violations of the respiratory and cardiovascular functions, the pleural cavity is urgently punctured and the contents are evacuated. The obtained material must be examined to clarify its nature and the main diagnosis. Perhaps the introduction of antibiotics, prednisolone or hydrocortisone into the pleural cavity, to reduce the phenomena of exudation. A drainage system is installed for several days.
When in the postoperative period, the accumulation of fluid in the chest should not be considered a complication?
If an operation was performed to remove the lung or part of it, an empty space is formed in the chest cavity, which is filled with fluid. “Nature abhors emptiness”, this is a kind of protective-compensatory reaction to maintain stable pressure in the chest cavity, which ensures the normal arrangement of the remaining organs.
Neither the heart nor the remaining lungs are displaced, which allows them to function normally. In the process of recovery, part of the fluid is absorbed, part is replaced by fibrin, forming adhesions. In this case, pleurisy is not a complication. In other operations, the appearance of pleurisy is considered a complication, the resulting fluid is removed and appropriate treatment is carried out.
Forecast
The prognosis of pleurisy is favorable, although it directly depends on the leading disease. Inflammatory, infectious, post-traumatic pleurisy is successfully cured and does not affect the quality of later life. Unless, during later life, pleural adhesions will be noted on radiographs.
The exception is dry tuberculous pleurisy, as a result of which fibrous deposits can calcify over time, the so-called armored pleurisy is formed. The lung is enclosed in a "stone shell", which interferes with its full functioning and leads to chronic respiratory failure.
To prevent the formation of adhesions that form after the removal of fluid from the pleural cavity, after treatment, when the acute period subsides, the patient should undergo rehabilitation procedures - this is physiotherapy, manual and vibration massage, it is necessary to carry out daily, using the Frolov breathing simulator).
The lungs are the main respiratory organ in the human body. The unique anatomical structure of the human lungs is fully consistent with their function, which is difficult to overestimate. Pleurisy of the lungs is caused by inflammation of the pleural sheets for infectious and non-infectious reasons. The disease does not belong to a number of independent nosological forms, as it is a complication of many pathological processes.
What is pleurisy of the lungs
Pleurisy of the lungs is one of the most complex inflammatory diseases, most severe in children and the elderly. The pleura is the serous membrane of the lung. It is divided into visceral (pulmonary) and parietal (parietal).
Each lung is covered with a pulmonary pleura, which, along the surface of the root, passes into the parietal pleura, which lines the walls of the chest cavity adjacent to the lung and delimits the lung from the mediastinum. The pleura, which covers the lungs, allows them to painlessly touch the chest during breathing.
The lungs are a paired organ. Every person has two lungs - right and left. The lungs are located in the chest and occupy 4/5 of its volume. Each lung is covered with a pleura, the outer edge of which is tightly fused with the chest. The lung tissue resembles a finely porous pink sponge. With age, as well as with pathological processes of the respiratory system, prolonged smoking, the color of the lung parenchyma changes and becomes darker.
Breathing is basically an uncontrolled process carried out on a reflex level. A certain area is responsible for this - the medulla oblongata. It regulates the rate and depth of breathing, focusing on the percentage of carbon dioxide concentration in the blood. The rhythm of breathing is affected by the work of the whole organism. Depending on the frequency of breathing, the heart rate slows down or speeds up.
Disease classification
Depending on the cause of the disease, the forms of manifestation of the disease can also differ and are divided into:
- Purulent pleurisy is a disease, the occurrence of which provokes the accumulation of a purulent effusion in the pleural cavity. At the same time, the inflammatory process of the parietal and pulmonary membranes is affected.
- pleurisy is characterized by damage to the pleura of an infectious, tumoral or other nature.
- Dry pleurisy is usually a complication of disease processes in the lungs or other organs located near the pleural cavity, or is a symptom of general (systemic) diseases.
- Tuberculous pleurisy affects the serous membranes that form the pleural cavity and cover the lungs. The main symptom of the disease is increased secretion of fluid or loss of fibrin to the surface of the pleura.
Distribution area:
- Diffuse pleurisy (exudate moves through the pleural cavity).
- Encapsulated pleurisy (fluid accumulates in one of the sections of the pleural cavity). It can be apical, parietal, basal, interlobar.
According to the nature of the lesion, pleurisy is divided into:
- escudative - fluid is formed and retained between the layers of the pleura;
- fibrous - the release of fluid is scanty, but the very surface of the pleural walls is covered with a layer of fibrin (protein).
Pleurisy is also divided according to the nature of distribution:
- only one lung can be affected
- both shares (one-sided and two-sided).
Causes
I must say that the disease in its pure form is rare. For example, its cause of development may be injury to the chest, its hypothermia. In most cases, it accompanies a disease or occurs as a complication of it.
Pleurisy of the lungs is characterized by the formation of fibrinous deposits on the surface of the pleural sheets and / or accumulation of exudate in the pleural cavity. Symptoms depend on the form of the disease.
The most common infection is pleurisy. An important role in the mechanism of development of pathology is played by the sensitization of the body. Microbes and their toxins lead to a change in the reactivity of the body and allergization of the pleura. The immune system begins to “send” the produced antibodies to the site of inflammation, which, when combined with antigens, affect the production of histamines.
About 70% of pathology forms are caused by bacterial agents:
- Streptococci;
- Pneumococci;
- Mycobacterium tuberculosis;
- Anaerobes;
- Mushrooms;
- Legionella;
- Tuberculosis.
The causes of non-infectious pleurisy of the lungs are as follows:
- malignant tumors of the pleura,
- metastasis to the pleura (with cancer of the breast, lung, etc.),
- diffuse connective tissue lesions (systemic vasculitis, scleroderma, systemic lupus erythematosus),
- lung infarction.
Is pleurisy contagious? To answer this question unequivocally, you need to know the cause of the pleurisy itself. If suffering is associated with a chest injury, then, of course, such pleurisy is not contagious. With a viral etiology, it can be quite contagious, although the degree of contagiousness is low.
Symptoms of pleurisy of the lungs
Patients often miss the onset of pleurisy because its symptoms are similar to the common cold. However, the signs of this pathology are still different from other respiratory diseases. You should be aware that the signs of different types of pleurisy are also different.
The very first and clear sign of pleurisy of the lungs is:
- Severe, fleeting, sharp pain in the chest, often on one side only, when breathing deeply, coughing, moving, sneezing, or even talking.
- When pleurisy appears in certain places on the lungs, pain may be felt in other parts of the body, such as the neck, shoulder, or abdomen.
- Painful breathing often provokes a dry cough, which, in turn, exacerbates the pain.
The rate of increase in symptoms also plays a big role:
- acute periods of pleural lesions are characterized by a rapid clinical take-off;
- for tumor and chronic forms - a calmer course of the disease
How does pleurisy of the lungs proceed in the elderly? In old age, there is a sluggish course and a slow resorption of the focus of inflammation.
Types of pleurisy | Description and symptoms |
Dry | Dry pleurisy develops at the initial stage of an inflammatory lesion of the pleura. Often, at this stage of the pathology, there are still no infectious agents in the lung cavity, and the resulting changes are due to the reactive involvement of blood and lymphatic vessels, as well as an allergic component.
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Purulent | Purulent pleurisy can form both with direct damage to the pleura by infectious agents, and with the independent opening of an abscess (or other accumulation of pus) of the lung into the pleural cavity. Patients with purulent pleurisy complain of:
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Exudative | In the period of accumulation of exudate, intense pain in the chest is disturbing. Symptoms are aggravated by deep breathing, coughing, and movement. Increasing respiratory failure is manifested by pallor of the skin, cyanosis of the mucous membranes, acrocyanosis. Typically, the development of compensatory tachycardia, lowering blood pressure. |
tuberculous | The clinical picture of tuberculous pleurisy is diverse and is closely related to the characteristics of tuberculous inflammation in the pleural cavity and lungs. In some patients, along with pleurisy, other manifestations of tuberculosis, especially primary ones (paraspecific reactions, specific damage to the bronchi), are noted. |
stages
Inflammation of the pleura develops in response to the introduction of pathogenic microbes and consists of 3 stages: exudation, formation of purulent discharge and recovery.
Exudate is a fluid that comes out of microvessels, containing a large amount of protein and, as a rule, blood cells. Accumulates in tissues and / or body cavities during inflammation.
1 stage
At the first stage, under the influence of the causative agent of the disease, the blood vessels expand, the degree of their permeability increases, and the process of fluid production increases.
2 stage
The stage of exudation gradually passes into the stage of formation of a purulent discharge. This occurs in the process of further development of pathology. Fibrin deposits appear on the pleural sheets, which create friction between them during breathing. This leads to the formation of adhesions and pockets in the pleural cavity, which impede the normal outflow of exudate, which becomes purulent. Purulent discharge consists of bacteria and their metabolic products.
3 stage pleurisy
At the third stage, the symptoms gradually subside, the patient either recovers, or the disease becomes chronic. Despite the fact that the external symptoms of the disease subside and cease to annoy the patient, inside the pathological processes gradually develop further.
Complications
What is dangerous pleurisy of the lungs? As a result of the formation of scars (moorings), individual blocks of the lung are blocked, which contributes to less air intake during inhalation, and as a result, rapid breathing.
Advanced forms of pleurisy can lead to the development of life-threatening complications - pleural adhesions, local circulatory disorders due to squeezing of blood vessels by exudate, bronchopleural fistulas.
The main complications of pleurisy:
- Purulent fusion of the pleura (empyema);
- Adhesions of the pleural cavity - a consequence of exudative pleurisy;
- Thickening of the sheets, fibrosis;
- Decreased respiratory excursion of the lungs;
- Respiratory, cardiovascular insufficiency.
The prognosis for such complications is very serious: mortality reaches 50%. The percentage of dying patients is even higher among the elderly and debilitated people, small children.
Diagnostics
If symptoms are found, you should immediately consult a doctor: in the absence of temperature, contact a local general practitioner; in case of unstable state of health or an associated infectious disease - to the emergency department
On examination, the diseased half of the chest lags behind in the act of breathing, this can be seen from the movement of the shoulder blades. When listening to the lungs, a very characteristic sound of pleural friction is determined. Radiography in acute dry pleurisy does not provide sufficient information. Laboratory tests will characterize the underlying disease.
After the patient has been diagnosed, fluid is taken from the pleura to determine what fluid accumulates in it. Most often it is exudate or pus, in rare cases - blood. It is noteworthy that the purulent form of the disease is more common in children.
The following examinations are used to diagnose pleurisy:
- examination and questioning of the patient;
- clinical examination of the patient;
- x-ray examination;
- blood analysis;
- analysis of pleural effusion;
- microbiological research.
Treatment of pleurisy of the lungs
If you have been diagnosed with pleurisy of the lungs, what it is, how to treat the disease, the attending physician will explain. If pleurisy of the lungs is suspected, the symptoms and all previous treatment are analyzed, and the patient is hospitalized.
Looking at the type of disease, certain medications are prescribed that help remove inflammation and reduce symptoms. But it is necessary not only to drink pills: you will need proper nutrition, exercise to restore the organs completely.
Drug treatment depends on the cause of pleurisy of the lungs, namely:
- If the disease is caused by pneumonia or acute bronchitis, then it must be treated with antibiotics;
- Tuberculosis requires a special regimen.
- Pain in pleurisy is treated with acetaminophen or anti-inflammatory drugs such as ibuprofen.
The type of drug depends on the cause of the disease. If it is infectious, antibiotics are used, if it is allergic, anti-allergic drugs are used.
In the early stage of fibrinous pleurisy of the lungs, half-alcohol warming compresses, electrophoresis with calcium chloride are recommended.
In the treatment of exudative pleurisy of the lungs, physiotherapy is carried out in the phase of resolution (resorption of exudate) in order to accelerate the disappearance of exudate, reduce pleural adhesions.
In case of exacerbation, patients are prescribed heating the chest with infrared rays, ultraviolet irradiation of the chest, daily paraffin applications. After the subsidence of acute inflammation - electrophoresis of calcium and iodine. A month after recovery, water procedures, exercise therapy, manual and vibration massage are shown.
Patients need to take a balanced diet and drink plenty of fluids. Also, the patient is prescribed a special diet, which is based on a lot of vitamins, proteins.
After discharge from the hospital, patients need to perform breathing exercises prescribed by a doctor to restore full lung activity. Showing moderate physical activity, long walks in the fresh air, yoga is very useful. It is especially useful for convalescents to be in a coniferous forest.
How to treat pleurisy with folk remedies
It is important to understand that it is impossible to treat pleurisy with folk remedies alone, since the disease can progress rapidly and lead to respiratory failure and suppuration of the effusion.
Treatment of pleurisy of the lungs with folk remedies consists in the use of compresses and the use of infusions, decoctions, tinctures.
- Beetroot juice helps with pleurisy. It is squeezed out of a fresh root crop, mixed with honey. For 100 g of juice, 2 tablespoons of honey are required. Take the remedy 2 times a day after meals. Each time you need to prepare a fresh portion, the composition does not need to be stored.
- Try to treat pleurisy with an infusion of herbs such as: mint, cudweed, coltsfoot, take a glass three times a day.
- Boil the roots (0.5 tsp) and rhizomes (0.5 tsp) of Caucasian hellebore in 0.5 l of water so that after evaporation a glass of liquid is obtained. Take 0.5 tsp. three times a day. The decoction is useful for the treatment of pleurisy, tuberculosis, heart failure.
- We mix honey and onion juice in equal portions (instead of onions, you can take black radish juice) - one tablespoon twice a day for the treatment of pleurisy.
- Infusion of a leaf of a plantain large or ordinary. For half a liter of boiling water, 2 tbsp. l. dried plant. The liquid is filtered and drunk warm, 100-120 ml 4 times a day. The drink is harmless, has a healing and antibacterial character.
Prevention
Very simple: it is necessary to adequately treat the primary infectious disease, monitor nutrition, alternate physical activity with quality rest, not overheat and not succumb to excessive cooling.
Remember that pleurisy is a consequence of another disease. Never interrupt treatment halfway through due to laziness or lack of time, and always try to avoid situations that can provoke an infection.