Fibrous pleurisy is a disease whose name speaks for itself. It manifests itself in the form of an inflammatory process in the pleura. Usually, the disease is a consequence of lobar ( lobar ) pneumonia. During this disease, a specific coating appears on the surface of the pleural sheets. Other causes for pleurisy can be a number of other diseases, such as rheumatism, lung injury, cancer, or tuberculosis.
Dry fibrinous pleurisy
It is a dangerous disease, since with it in the pleural cavity there is no light exudate, which contains a certain amount of fibrin. As a result, the accumulated fluid washes the pleural leaves, after which fibrinous deposits accumulate, which increases the thickness of the pleural wall. In the future, there is a process of replacing the walls of the pleura with fibrinous tissues. Dry pleurisy is detected during the onset of the disease, when the tissue is just beginning to become inflamed. It covers cough receptors, as a result of which the infected person begins to cough.
Etiology of the phenomenon
If an inflammatory process occurs in the body, then there is a risk of pleurisy, in particular patients are affected by this disease, the inflammatory processes of which occur directly in the lungs or in organs located close to the pleura. Based on what is the impetus for the development of this disease, all causes can be divided into aseptic and septic. The first category is characterized by many chronic or pathological diseases. A vivid example is the lupus erythematosus or uremia, which developed as a result of renal failure. As a rule, with uremia, nitrogen scales accumulate on the pleural sheets, and those, in turn, irritate the pleural walls.
To septic diseases, that is, to infectious, include: SARS, lung abscess, tuberculosis and pneumonia of all types.
People are susceptible to this disease if:
- They are constantly in a nervous state.
- Frequent cooling due to the profession.
- Overwork.
- They are prone to severe tolerance to chemicals.
- Do not support a healthy lifestyle.
Symptomatic manifestations
A reliable auscultatory sign of fibrinous pleurisy is the friction characteristic of this disease in the pleura. Sometimes this sound resembles a crunch of dry snow. In addition, its brightest signs are: painful, dry, severe cough, pain in the chest area or even hiccups. Moreover, patients suffer from high fever or chills, shallow breathing, weakness and sweating are observed. On x-rays with fibrinous pleurisy, a bright lag in breathing is traced from the affected side. In medical practice, the most difficult and main task is to timely distinguish pleurisy from fracture of the ribs or from intercostal neuralgia.
Pathology stages
Fibrinous pleurisy is the body's response to foreign bodies (microbes), developing in three stages:
- In the first stage, the infected person dilates blood vessels. They turn out to be permeable and prone to various damage. As a result, the amount of accumulated liquid increases sharply.
- The second stage is characterized by the formation of purulent mass, so pathology gradually develops. Certain deposits, which are known as fibrin deposits, create friction on the pleura during breathing. The pleural cavity is filled with pockets and commissures. All this violates the decrease in exudate. In general, the outcome of the above is a purulent formation.
- The patient’s recovery process belongs to the third stage; all disorders that have occurred in the body gradually come back to normal thanks to medications and various procedures. However, the disease does not leave the patient’s body - it goes into the chronic stage and hides in the body, but often does not manifest itself in the future. A person becomes much better, although the infection cannot be called completely defeated.
Parapneumonic left-sided fibrinous pleurisy
A striking feature of this disease is intrapulmonary left-sided abnormal inflammation, which was confirmed by x-ray examination. This inflammation is characterized by a sharp regression during antibiotic therapy. Treatment does not take a long period, in the early stages of the disease it is easy to treat.
Serous
Serous fibrinous pleurisy is detected during the defeat of the mediastinal nodes and lymph nodes. Tuberculosis is the main reason, the source for the manifestation of this disease. The allergic process, perifocal inflammation and tuberculous lesion of the pleura are the three most important factors for the development of pathology. In its characteristics, it resembles ordinary pleurisy. This is due to the fact that the initial stage of this type of disease is dry fibrinous pleurisy. Two types of pleurisy, serous and serous-fibrinous, have their similarities and differences. The causative agents of such ailments include a number of viral diseases, as well as the infamous typhoid, syphilis, diphtheria and periarteritis nodosa.
Based on the location of the tumor itself, diaphragmatic, mediastinal (posterior, anterior, left lateral, right, etc.), parietal (clasp-like, interlobar) species are distinguished.
Purulent pleurisy
It develops subject to the presence of Pseudomonas aeruginosa and pathogenic bacteria in the body. This stage of the disease is the most difficult. Pathogens can provoke pleurisy in the aggregate and individually. The basis for this disease is staphylococcal destruction of the lungs. Moreover, esophageal ruptures are another focus of this disease. With a similar pathology, pleural scarring is detected, which becomes the result of the accumulation of a large amount of pus in the pocket, that is, in the free cavity. In the initial stage, the disease is acute purulent pleurisy, and in the future it develops to a chronic form. The outcome may be favorable if the patient recovers and the tumor heals.
In the modern world, there are seventy-four pathogens of this disease. Rural residents are at particular risk of infection, since there are the most optimal conditions for the reproduction and survival of viruses. When the causative agents of tuberculosis enter the uninfected zone (in addition to the lungs, also skin, bones, lymph nodes, etc.), they begin reproduction, which leads to serious consequences. Soon in the zone of development of inflammation, tubercles are formed that have the property of self-absorption or increase.
Unfortunately, fibro-purulent pleurisy is contagious, respectively, it is transmitted by airborne droplets.
Diagnostic measures
One of the most important and most difficult tasks on the path to recovery is the correct diagnosis of the disease. The most common way to detect pleurisy is considered to be x-rays.
A general blood test reveals leukocytosis, increased ESR or anemia. In addition, a urinalysis indicates the presence of epithelium or red blood cells. The content of total protein, as well as foreign bodies (fibrinogen or sialic acids) is determined thanks to a biochemical blood test.
It is possible to identify fibrinous-purulent pleurisy with the help of a micropreparation. Micropreparation - a glass slide on which the studied unit is placed. Using a microscope, objects of infected areas are examined. Fibrinous-purulent pleurisy is shown below on a demonstration micropreparation.
Treatment principles
Given that pleurisy is a secondary disease, it should be treated in parallel with the root cause. It is necessary that the therapy be comprehensive. The goal of treating fibrinous pleurisy is to relieve pain in the patient and eliminate the tumor as soon as possible. And in the future, all measures are taken to eliminate complications.
The treatment itself includes taking medications, often these are strong antibiotics. In no case should you avoid or refuse auxiliary procedures, such as physiotherapy or pleural puncture. The general course of treatment includes:
- Drugs that reduce pain.
- Medicines with warming properties.
- Cough suppressants.
It must be borne in mind that placing a patient in a hospital is an essential condition for recovery, since all procedures will be carried out directly by experienced physicians on an ongoing basis until the patient is completely cured.
Experts also advise not to use any folk remedies and to avoid self-treatment at home, since activities of this kind lead to irreversible consequences that seriously affect the well-being of the patient.
During the illness, the attending physician prescribes a special diet, which is characterized by a high protein content and an almost complete absence of fluid.
Another necessary condition for the recovery of the patient are regular walks in the fresh air and massages. In order to avoid the spread of pathogenic microorganisms, similar measures should be taken during the rehabilitation period.
Possible complications
Despite the fact that fibrinous pleurisy is itself a complication after other pulmonary diseases, in the context of illiterate or unstable treatment, certain complications may arise. These include:
- The development of adhesions in the pleural cavity.
- Pleurosclerosis
- An increase in pleural leaves.
- Enlarged moorings.
- The immobility of the diaphragm dome.
- Respiratory failure.
Another important point may be the property of the inflamed pleura to merge with other organs, such as the heart, which sometimes even with surgical intervention causes serious damage to health and causes serious consequences.
Rehabilitation
Even after completely getting rid of this ailment, you should visit sanatoriums for the first 2-3 years. If the treatment was carried out correctly and all the necessary procedures were performed, then complications should not arise. In case of untimely initiation of therapy or weak immunity, valvular pneumothorax may occur . However, its treatment is not difficult, and it is extremely rare.
In conclusion, one cannot help but recall that fibrinous pleurisy is a serious disease. It cannot resolve itself, so attempts to treat it independently, without experienced specialists, only worsen the patient’s well-being. As a result, sooner or later he still ends up in the hospital, but the disease by this time is already too neglected. Unfortunately, deaths are known in medical practice, but they occurred decades earlier, and then very rarely. You should pay more attention to your health and, at the slightest change in well-being, consult a specialist.