Treatment of dry pleurisy will help patients get rid of a rather dangerous reactive inflammation of the visceral and parietal pleura, in which fibrin falls on its surface. Typical symptoms of this disease are associated with chest pain, which is aggravated by breathing, as well as low-grade fever, dry cough, and general malaise. It is possible to diagnose this condition with the help of auscultatory and clinical data, ultrasound of the pleural cavity, x-ray. The main treatment for this ailment is aimed at eliminating the primary pathology - as a rule, it is acute pneumonia or tuberculosis, as well as associated symptoms. With this disease, a doctor may prescribe anti-inflammatory, analgesic, and antitussive drugs. The treatment tactics, symptoms, diagnosis and characteristics of the disease will be discussed in this article.
Varieties
Treatment of dry pleurisy is almost always prescribed strictly individually. By a similar general term in pulmonology it is customary to denote a group of inflammatory lesions of the pleura of various origins.
In some cases, pleurisy can be independent or primary, but usually develop as a secondary disease against a background of chronic or acute processes occurring in the lungs.
Depending on the presence or absence of effusion, several types of pleurisy are distinguished: they can be dry (or fibrinous), as well as exudative (serous-fibrinous, serous, purulent or hemorrhagic).
By their origin bacterial pleurisy is found (they can be specific or non-specific), as well as tumor, viral, and traumatic.
Causes and mechanisms of the development of the disease
Most often, fibrinous pleurisy is inherently associated with tuberculosis of the lymph nodes inside the chest or pulmonary tuberculosis. Having a tuberculous origin, dry pleurisy is formed when the foci are subpleural, as well as when they break into the pleural cavity when it is seeded. It can also develop due to hematogenous drift of pathogens.
As the causes of pleurisy in this situation, all kinds of non-specific lung lesions are called. It can be bronchiectasis, pneumonia, abscesses, heart attacks or lung cancer.
Possible complications
With the development of extrapulmonary dry pleurisy, they can be complicated by diseases of the digestive system. For example, pancreatitis, cholecystitis, subphrenic abscesses.
In some cases, the disease can be complicated by infections (typhus or typhoid, brucellosis, measles, whooping cough, flu) or collagenoses (rheumatism, systemic lupus erythematosus, systemic vasculitis).
Sometimes dry pleurisy is accompanied by uremia or an eating disorder.
Pathogenesis
The pathogenic basis of this disease is the inflammatory reactions of the visceral and parietal pleura, which occur with edema, hyperemia, and thickening of the pleural sheets. At the same time, the amount of exudate will be so insignificant that it may begin to be reabsorbed by the pleura with the settling of fibrin filaments on the pleura surface. It is formed in the form of characteristic pleural overlays, which greatly complicate the sliding of the leaves.
In the future, this may lead to limited lung mobility and the appearance of massive moorings.
Most often, dry pleurisy (especially if left untreated) develops into exudative. But in some cases, everything can be resolved without pleural effusion.
Symptoms
When the rib pleura is affected by dry pleurisy, characteristic pains begin in the corresponding half of the chest. To effectively treat dry pleurisy, the symptoms should be familiar to everyone. Then the disease can be quickly determined to consult a doctor for appropriate help.
With this pathology, pain will increase on exhalation, as well as straining, coughing. All this forces the patient to lie only on the sore side, which greatly limits the mobility of the chest. The need to begin treatment of dry pleurisy according to the symptoms can be easily determined by any doctor.
With this disease, during the subsidence of the activity of the inflammatory process, there is a significant decrease in the sensitivity of the nerve endings of the pleura. All this is accompanied by the fact that the pain subsides.
Signs of inflammation
You can also find out about the symptoms and treatment of dry lung pleurisy at a consultation with a pulmonologist. It will not be superfluous to know the characteristic signs of this pathology.
With inflammation of the phrenic pleura, the pain concentrates in the abdominal region. In this case, pancreatitis, acute cholecystitis, appendicitis may appear. With dry apical pleurisy, the pain is transferred to the projection of the trapezius muscle, and when the pericardium is involved in inflammation, pleuropericarditis is formed.
What are the signs of dry lung pleurisy in adults noted by a doctor? In fibrous pleurisy, the patient can observe the general symptoms of almost any inflammation - loss of appetite, malaise, sweating at night, as well as a dry cough. At the same time, the patient’s body temperature with such an ailment can be either normal or significantly high, reaching 38-39 degrees. The resulting fever is accompanied by tachycardia and chills.
The total duration of the course of the disease is from one to three weeks, depending on the body's response to therapy, severity, and many other related factors. In this case, the final outcome may be a complete cure or the transition of pleurisy to an exudative form. In some cases, the disease becomes chronic - then finally it can not be defeated until the end of life. In the latter situation, pleurisy lasts several months with periodic exacerbations.
Diagnostics
It is worth noting that formal diagnostics for determining dry pleurisy is considered insufficient. The doctor always needs to establish the cause of the disease, and not just eliminate its symptoms. Therefore, if you suspect a given disease, the patient should consult with a number of specialists. This is a rheumatologist, pulmonologist, gastroenterologist, TB specialist, infectious disease specialist.
Auscultatory, that is, physical, signs of this disease include significant weakening of breathing on the affected side, extensive or localized pleural friction noises during listening. It is worth noting that the noise of friction of the pleura occurs when the rough pleural sheets are in direct contact with each other. It can be almost elusive. In some cases - pronounced. On palpation, the doctor manages to establish soreness and muscle stiffness.
Research
To begin treatment of dry pleurisy of the lungs, various studies are carried out. For example, obliteration of the sinuses, restriction of excursion of the diaphragm on the affected side of the disease, as well as a change in its contour or high standing, are noted on lung radiography and fluoroscopy. In particular, the contour of the diaphragm can become atypical - for example, with seals, irregularities, bulges. To exclude the presence of exudate, an ultrasound examination of the pleural plane is prescribed. This is an important diagnostic procedure that allows you to determine at what stage of development the disease is.
It is important to differentiate dry pleurisy from myositis, intercostal neuralgia, angina, rib fracture, myocardial infarction. The latter options can be eliminated using an electrocardiogram. All of these diseases can have similar symptoms and signs. It is important to establish what kind of problem the patient has and what he should be treated for. Only a professional doctor can do this according to the results of a full-fledged diagnostic examination. So self-medication is strictly prohibited when the first such signs appear. Only a doctor can make an accurate diagnosis and prescribe an effective treatment for dry pleurisy.
Treatment methods
For the reason that in most cases, dry pleurisy is a secondary process, the root cause should be established. Moreover, the main treatment for dry pleurisy is actually aimed at eliminating just the primary disease.
If the patient has a fibrous variety of this disease, which has a tuberculous origin, then anti-tuberculosis therapy with the help of drugs is recommended. It can be "Tubazid", "Streptomycin", "Rifampicin", as well as many others. If non-specific inflammation of extrapulmonary and pulmonary localization appears, in addition to anti-inflammatory, the patient will also need antibiotic therapy.
With drug treatment of dry pleurisy of the lungs, it is important to alleviate pain syndromes. To do this, in addition to taking the appropriate drugs, you should put a tight tight bandage on the chest, strictly observe bed rest, put mustard plasters, warming compresses. To stop the cough, which, as a rule, greatly torments the patient, classic antitussive drugs are used. These are Ethylmorphine, Codeine, and others.
If the patient has a relapse of dry pleurisy, doctors apply pleurectomy, removing the visceral and parietal pleura, which together begin to form a purulent cavity.
Drugs for the infectious nature of the disease
Often there is enough conservative treatment of dry pleurisy of the lungs. Drug treatment is possible with its infectious nature. In this case, antibacterial drugs are prescribed, the choice of which depends on the patient's sensitivity to a particular antibiotic and the type of pathogen.
Depending on the nature of the pathogenic flora, drugs can appear in the form of:
- cephalosporins ("Ceftriaxone", "Mefoxin", "Latamoxef", "Keiten", "Cefepim", "Cefpir", "Ceftolosan", "Zefter");
- penicillins (Oxamp, Sultasin, Amoxiclav);
- glycopeptides ("Targocid", "Vancomycin", "Vibative").
Also, preparations in the form of fluoroquinolones, carbapenems, macrolides, aminoglycosides, ansamycins, lincosamides, amphenicol, tetracyclines, and other antibacterial synthetic agents can be used as therapy.
The development of exudative pleurisy
As we have already noted, dry pleurisy often flows into exudative. In this case, the patient has both objective and subjective complaints. The latter include a feeling of heaviness in the chest, dry cough, sweating, fever, headache.
In the treatment of dry and exudative pleurisy, the Traube space, which had previously practically disappeared, begins to recover. This occurs in the lower chest on the left side.
How to deal with exudative pleurisy?
It is worth noting that the treatment of exudative and dry pleurisy is somewhat similar, although it has some differences.
For example, in the latter case, pathogenetic therapy, evacuation of exudate is required. Etiological treatment consists in influencing the primary source of the disease.
Also in the treatment of dry and exudative pleurisy along the wedge. recommendations are advised to use diet therapy. It is necessary to include more proteins, vitamins in the diet, limit the intake of water and salt. General strengthening exercises have a beneficial effect. When acute manifestations of the disease pass, breathing exercises and a light massage of the chest can be done. It is important to understand that any manipulations should be performed only after consultation with a treating specialist.