The symptoms and treatment of pleurisy
Inflammatory disease of the pleura of the lungs (pleurisy) symptoms is different. They depend on the type of disease, localization, causes. Pleurisy is diagnosed not only in adults but also in children.
What is pleurisy?
The pleura is a film consisting of 2 sheets. One covers the surface of lungs and lines the second chest. Between these sheets there is a space called the pleural cavity. In case of accumulation of fluid (exudate) begins to develop inflammation. Exudate is formed from a liquid component, plasma, and blood protein. They seep into the pleural cavity through the vessels of the pleura, which become permeable under the influence of various factors (e.g., autoimmune processes).
With a slight amount of fluid is reversed its absorption. But protein is deposited in the pleura and is not absorbed. Because of this deposition film is thickened, the surface becomes rough, which gradually leads to the development of dry pleurisy. If the liquid is a lot, she is unable to be absorbed fully and accumulates in the pleural cavity. In this case, it comes exudative pleurisy of the lungs. It is sometimes called exudative.
Pleurisy is rarely an independent disease. It usually accompanies some kind of underlying disease, for example, the development of the pathology in the lungs. Therefore, no data on the incidence of and mortality from TB, pleurisy is registered under the major disease. The disease is divided into several types according to what are the signs of pleurisy. The cause of the disease is divided into 2 types:
- infectious, that is, a pleurisy caused by fungus, viruses, bacteria and protozoa;
- noninfectious or aseptic, which is not associated with infections, the cause of its appearance are malignant neoplasms, injuries of chest, rheumatism and other diseases.
Shares pleurisy and on developments in the inflammatory process:
- dry, that is, one in which the fluid accumulates in the pleural cavity;
- exudative, or exudative, where fluid accumulates in the cavity.
Distribution of pleural effusion by locating the following:
- diffuse and covers the entire pleural cavity;
- local, or limited, affects only the specific location of the cavity.
Symptoms of dry pleurisy
In dry pleurisy the symptoms observed are very characteristic. Starts with a General malaisethe increase in body temperature of the patient. From the first days of developing a dry cough. When you inhale or cough occurs, the chest pain, in the half, where he developed inflammation. The same thing happens with sneezing. To alleviate the patient lies on the healthy side. Breathing in this patient is shallow and rapid.
Inflamed pleura has a rough surface unlike the smooth in a healthy condition. When the person is breathing, inflamed areas come into contact, causing friction. Therefore, there is pain. A doctor examining a patient, hears a noise from this friction. Gradually the noise becomes stronger, and the patient hears it, if you put your palm on the affected area of the body. Uncommon inflammation of the pleura shows the development of tuberculosis in the lungs. Therefore, the pleurisy must be treated, not to run and not wait until dangerous complications.
This type of pleurisy of the lungs continues for about 2 weeks. It does not go into pneumonia. In that case, if the disease lasts longer, perhaps the onset of exacerbations. The patient is sent to check if he has tuberculosis. If pleurisy was part of the pneumonia, its symptoms will disappear simultaneously with the cure of the primary disease. Usually a dry pleurisy is without consequences, and pretty quick. Inflammatory foci resolve, the pleura returns to its normal appearance. But sometimes, acute pleurisy promotes fusion sites affected by inflammation, among themselves. In the end, there adhesions, and ill light is limited in movement.
The symptoms of exudative (exudative) pleurisy
This pleurisy is accompanied by several other symptoms. In the pleural cavity of adult patients sometimes accumulate to 100 ml. If it contains particles of blood, it is called a hemorrhagic exudate. If fluid enters the pathogenic microorganisms, it becomes purulent.
At first signs of disease similar to the symptoms of dry type of the disease. The patient feels chills, his condition deteriorated, the thermometer shows higher temperature, lose their appetite. Dry cough, excessive sweating, constant pain in your side - all this is observed in the patient. The symptoms go further filling fluid of the pleura and can be stopped altogether. The patient feels better. But do not think that he recovered. The volume of fluid in the pleura is gradually becoming more. Starts shortness of breath, increasing with time. Blood circulation worsens. Shifting of organs: heart, blood vessels, trachea. They begin to put pressure on the lungs.
Exudative pleurisy lasts about 7 weeks. If the treatment is carried out, health is gradually getting back to normal: the temperature is reduced, the exudates decrease, the patient's sleep and appetite are restored.
The most severe form of exudative pleurisy - purulent. Occurs as a complication of pneumonia or tuberculosis. Signs appear acutely: fever, severe shortness of breath, the morning temperature is very different from the evening. The function of the heart worsens the adhesions, which are particularly characteristic of this type of disease. Pleurisy is dangerous complications. So you should not squander precious time trying to alleviate their condition on their own. Need qualified treatment.
How to diagnose illness?
Diagnosis of pleurisy consists of an external examination of the patient by a physician, laboratory tests, and radiography. The first thing the doctor listens to the lungs with a stethoscope at different respiratory phases. At this moment the noise is detected friction in the pleura, which indicates the dry form of the disease. If pleurisy exudative form, while rapping doctor separate areas identifies specific sounds in the place, where the accumulated liquid. So the specialist assesses the affected area of the cavity of the pleura.
The patient is sent for blood - the General analysis and biochemical. Results observed changes in its composition: erythrocyte sedimentation rate accelerated, increased leukocytes and a number of others. Then held diagnostics - radiography. With her help the doctor see the affected area and will be able to understand the nature of the inflammation in the pleura. In dry pleurisy, the chest x-ray will show how restricted the pulmonary region, in a moment of breath, as summarized pleural layers. For this type of disease to diagnose more informative clinical tests.
In exudative pleurisy on the radiograph (which in this case is more informative than laboratory tests) will be seen in reduced light, and below it is a liquid, which may be homogeneous or interspersed with any substance (pus or blood).
The treatment of the disease
In dry pleurisy the patient shows outpatient treatment. In other cases, the patient has to be hospitalized. If the disease is burdened with pus, the patient is treated in the surgical Department or in therapy. If the volume of fluid in the cavity is considerable, the patient is prescribed bed rest. The remaining patients cost polupostelny regime, they are allowed to move for better drainage of the bronchi.
Patients diagnosed with the dry form of pleurisy, appointed anti-inflammatory and pain relievers. Use a hot compress. The patient is tight compression of the breast using a special corset. Using special warming ointment. If there is evidence, then used antibacterialdrugs. Patients with exudate in the pleural cavity it is necessary to observe a special diet. It excludes foods with a lot of liquid.
The patient held puncture to remove fluid or drainage. In one session pumped out less than one and a half liters of fluid. More impossible, because the possible complications in the heart.
If the fluid is pus, the pleural cavity definitely is washed with antiseptic solutions.
In severe cases, the doctor resorts to surgery. During the operation is removed in some areas of the pleura. This is done to prevent the repeat of the disease. As soon as the exudate will be absorbed, the patient receives physiotherapy treatment. He also illustrates medical and breathing exercises. If the treatment is successful, the complications from it usually does not happen. If the patient was purulent pleurisy or treatment was not successful, possible complications. It could be adhesions, heart failure etc.
Prevention as such to prevent pleurisy exists. It is important to observe the usual rules: do not SuperCool, time to go to the hospital for various diseases that can cause pleurisy.