Pleurisy is an inflammation of the pleural sheets, which can be either an independent disease, or a consequence of chronic or acute processes occurring in the lungs. True, separately from other ailments, it rarely occurs. It is very important to immediately pay attention to the symptoms of pleurisy and consult a doctor, otherwise then you will have to deal with the consequences. What signs indicate the presence of this disease? What causes it? How to treat him? This and much more will now be discussed.
Causes
Before proceeding to the consideration of the symptoms of pleurisy, it is necessary to study the reasons why this disease occurs. They can be infectious:
- Tubercle bacillus. According to statistics, this is a provoking factor in 20% of cases.
- Bacteria. These are, as a rule, pneumococci, staphylococci, etc.
- Parasites and simple microorganisms (falling into the body of echinococcus, amoeba).
- Fungal lesions (blastomycosis and candidiasis).
- Typhoid, brucellosis, syphilis.
- Infection due to penetrating wounds and injuries.
Also, the disease often appears for non-infectious reasons. These include:
- Pulmonary embolism, also called lung infarction.
- Organ metastases or malignant tumors that arose in the pleura.
- Pathology of connective tissue. These are vasculitis, systemic lupus erythematosus, as well as rheumatoid arthritis.
- Chronic renal failure.
- Myocardial infarction.
- Other diseases (hemorrhagic diathesis, leukemia, pancreatitis, etc.).
In addition to the above, the disease can occur due to chest injury.
Dry pleurisy
It manifests itself in reactive inflammation of the visceral and parietal pleura with the loss of fibrin, a high molecular weight protein formed from the fibrinogen synthesized in the liver, on its surface. Symptoms of dry pleurisy are as follows:
- Pronounced pains felt in the corresponding lesion half of the chest. They increase with straining, coughing, as well as at the height of inspiration.
- Subsequent localization of pain in the abdominal cavity. Signs appear that are similar to symptoms of pancreatitis, appendicitis and cholecystitis.
- Dry cough.
- Common signs of inflammation, which include decreased appetite, malaise, and night sweats.
- Pain in the projection of the trapezius muscle.
- Temperature increase up to 39 ° .
- Fever accompanied by tachycardia and chills.
In especially severe cases and when the disease is ignored, pleuropericarditis, an inflammatory lesion of the serous membrane of the heart, may occur. It should be noted that the clinical course of this disease is from 1 to 3 weeks. The outcome, depending on the actions taken by the sick person, may be recovery or transition to exudative / chronic form.
Diagnosis of dry pleurisy
Briefly worth mentioning about this. Confirm the symptoms of pleurisy can only diagnosis and a thorough examination, and several specialists. A person will have to contact an infectious disease specialist, a rheumatologist, a pulmonologist, a gastroenterologist and a TB specialist. Because formal diagnosis is not enough - it is necessary to identify the cause of this disease.
Specialists resort to the following methods for identifying a disease:
- Clinical blood test. With this disease, an increased erythrocyte sedimentation rate is observed, as well as neutrophilic leukocytosis with a shift to the left.
- X-ray of the organs of the thoracic department. Usually, it is possible to detect reduced mobility of its lower edges and barely noticeable bulging of the pulmonary field.
- General urine analysis. It is necessary to exclude pathological changes.
- Blood chemistry. Symptoms of pleurisy are confirmed if it is possible to identify an increased amount of fibrin, seromucoids, sialic acids and other acute phase indicators.
- Ultrasound Allows you to determine whether the walls of the shell are thickened and whether there is a layering of deferred fibrin.
- X-ray and fluoroscopy of the lungs. This method makes it possible to identify many lesions - starting with obliteration of the sinuses and ending with a change in the contour of the diaphragm.
A tactile examination by a doctor reveals muscle soreness and stiffness. Also, the doctor records a weakening of breathing and an extensive or localized pleural friction noise. It occurs due to the contact of rough pleural sheets. Be sure to conduct a detailed diagnosis of symptoms of dry pleurisy. Otherwise, treatment cannot be prescribed, since the signs of this disease are similar to some manifestations of angina pectoris, intercostal neuralgia, myositis, etc.
Dry pleurisy treatment
If it was possible to identify the ailment at an early stage, when it has not yet passed into a complicated form, then it will take about two to three weeks to treat. Therapy is prescribed by the doctor to eliminate the symptoms of lung pleurisy, but, as a rule, the following drugs are prescribed to patients:
- Clindamycin. Effective bacteriostatic agent, whose action is aimed at inhibiting protein synthesis, as well as the destruction of microaerophilic and anaerobic parasitic bacteria.
- Cephalosporins III generation. These are powerful antibiotics that have increased activity against gram-negative bacteria, also affecting Pseudomonas aeruginosa and many other bacteria that negatively affect the body.
- Amoxicillin. An antibiotic belonging to the group of penicillins with a wide spectrum of action. It is prescribed together with clavulanic acid. This substance interacts with penicillin preparations, enhancing their activity.
- Imipenem. This is a beta-lactam antibiotic that suppresses the synthesis of the bacterial cell wall, and also destroys parasites belonging to various groups.
These drugs are aimed at eliminating the symptoms of pleurisy of the lungs and treating the disease itself. But in parallel it is necessary to carry out correction of protein metabolism. To do this, a person must follow a protein diet. In severe cases, the doctor may prescribe the introduction of a 10 percent albumin solution in a volume of 150 ml and blood plasma (200 to 400 ml).
To reduce inflammation, the patient is prescribed taking steroid hormones:
- "Hydrocortisone." It suppresses the functions of tissue macrophages and leukocytes, restricts their migration to the area of inflammation and reduces the concentration of proteolytic enzymes in it.
- "Prednisolone." Reduces capillary permeability, inhibits collagen formation and fibroblast activity.
- Metipred. It has an immunosuppressive, anti-allergic, as well as anti-inflammatory effect.
Non-hormonal drugs are also prescribed. Of the most famous, one can mention Movalis, Diclofenac, Voltaren and Ibuprofen.
To prevent the formation of adhesions in the pleural plane, procedures such as breathing exercises, vibration or classical massage, as well as physiotherapy help. But the doctor will approve their conduct only after the symptoms of lung pleurisy are eliminated, and the treatment can be transferred to a sparing form. Since the disease in question has a difficult etiology and can be caused by tuberculosis, the patient must be in the dispensary under the supervision of a TB doctor and undergo specific preventive treatment during the course of treatment.
Pleurisy effusion
It is also called exudative. Before listing the symptoms of pleurisy of this type, it is worth talking about how it is formed. The disease is an inflammatory process in the membrane of the lungs, accompanied by the formation of pleural effusion - excess fluid.
In addition to the previously mentioned reasons, this ailment can form under the influence of such factors:
- Parasitic infestations (parasite infection).
- Drug allergies.
- Diseases accompanied by disorganization of connective tissue.
- Thermal or chemical burns.
- Uremic pleurisy (happens when the balance of nitrogen and its compounds is disturbed in the body).
- Impaired blood circulation.
Symptoms of lung pleurisy of this type include:
- Clearly defined ribs in the area where fluid accumulates.
- Fatigue and weakness throughout the body, observed even in the absence of physical exertion.
- Cyanotic shade of the skin.
- Sensation of heaviness on the part of localization.
- Lack of air, the occurrence of related panic.
- Acceleration of the heart rhythm, the development of arrhythmia.
- A constant desire to lie on the side affected by the disease. So the discomfort subsides a bit.
But the most dangerous symptom is moving the heart muscle to a healthy side. The inferior vena cava may be bent, through which blood is supplied to the heart. Because of this, the blood supply is disturbed, and this can lead not only to serious consequences, but also to death.
Treatment of effusion pleurisy
If the above methods are used to diagnose the disease, then it is eliminated by other means. It was described above what pleurisy and its symptoms are. The treatment now also needs to be given a little attention.
Here are the procedures the patient will have to go through:
- Taking puncture. It is necessary both for diagnostics and for pumping out liquids. It is done once, since then commissures are formed. It is possible to pump out up to 1.5 liters.
- Taking antibiotics. It is prescribed if the disease provoked the development of bacteria.
- Passing a course of codeine-containing drugs. This is necessary for the discharge of sputum.
- Taking antihistamines that suppress the action of free histamine. The most popular medications are Diazolin, Erius, and Cetrin.
- The use of antipyretic drugs. Without them, it is difficult to eliminate inflammation. Best of all helps Medics and Ibuprofen.
- Taking painkillers. The best drugs are Nimesil, Cefecon, Tramadol, and Nise.
- The use of diuretics. The most effective are Indapamide, Veroshpiron and Diacarb.
With the help of these funds, the treatment of symptoms of pleurisy of the lungs in elderly and middle-aged patients. In severe cases, the doctor may prescribe glucocorticosteroids. They have a very wide spectrum of action. These drugs give antitoxic, immunosuppressive, anti-inflammatory, anti-shock and desensitizing effects. In the absence of contraindications, the doctor may prescribe inductothermy, diathermy, electrophoresis, massage, chest irradiation with ultraviolet light, mud wraps and paraffin baths.
Purulent pleurisy
This is the third type of disease that I would like to talk about. This ailment is characterized by accumulation of pus in the pleural cavity. Together with the parietal membrane, the pulmonary is also affected. As a rule, this disease is a complication that occurs after pneumonia of the influenza or croupous type.
Symptoms of lung pleurisy in adults in this case are:
- Inability to take full breaths, difficulties in this process.
- Stitching pains in chest area.
- Pronounced shortness of breath.
- Cough, accompanied by sputum, if the disease arose after lung abscess or pneumonia.
- Significantly increased body temperature.
- Pain in the lateral area.
- Severe weakness.
- Attacks of coughing at night.
If you ignore the disease, then over time, an elevated temperature will become a passing norm, and the pulse will stably stay in the range from 120 to 130 beats per minute. In the worst case, there may be a transition of air masses and pus into the pleural cavity. This is due to a breakthrough of the lung abscess. The result is pleural shock.
Treatment of purulent pleurisy
It cannot be ignored. In the case of this form of the disease, the symptoms of pleurisy in adults are more difficult to eliminate. The main task is to eliminate the infection and signs of intoxication beginning to manifest itself. You will also need to restore the full work of diseased organs.
First of all, the doctor eliminates the purulent focus, and then straightens the lung. Then you need to wait a little time for the pleura to grow together. After that, obliteration of the cavity of the focus should occur. Only then the doctor prescribes a treatment that helps prevent the appearance of moorings in the pleural region, which can provoke the transition of the disease into a chronic form.
The basis of therapy is the procedure for pumping exudate. It is performed in parallel with the intramuscular injection of penicillin into the cavity. In especially difficult situations, the doctor prescribes a transfusion of red blood cells or plasma. If the patient is in very poor condition, then surgery is indicated aimed at resecting the rib.
Folk remedies
And it is necessary to talk about them, since we are talking about the symptoms of pleurisy. Treatment with folk remedies can be a good concomitant therapy, but it is allowed to carry out it only after consulting a doctor, as there may be contraindications. Here are some simple and effective recipes:
- After each meal you need to drink 1/4 cup freshly squeezed cherry juice with pulp.
- In equal proportions, carefully mix honey and squeezed juice from the bulbs. Drink the resulting mixture twice a day after meals, 1 tablespoon.
- Mix a glass of aloe juice with the same amount of linden honey and vegetable oil. Add dried birch buds (100 g) and lime blossom (50 g). Simmer for 40 minutes. Drink 2 tablespoons after each meal.
- Mix 1 teaspoon of mint leaves and coltsfoot. Pour a glass of boiling water and let it brew for three hours. Divide the resulting volume into three servings and drink after breakfast, lunch and dinner. Every day, make a new infusion and take for a week.
Treatment with folk remedies for symptoms of pleurisy of the lungs and its complications will become effective only if the person also follows medical recommendations. Be that as it may, medications are most effective.
In the case of oversized patients
The symptoms and treatment of pleurisy in the elderly should be discussed separately. It is important to make a reservation that they are the most vulnerable due to age. They often experience stagnant processes, and those who are forced to lead a sedentary lifestyle also have swelling of the extremities. In addition, often this disease is a consequence of arthritis, which occurs in the vast majority of over-aged people.
If we talk about treatment aimed at eliminating the symptoms of pleurisy in the elderly, then there will not be particularly obvious differences. The only caveat - hormonal drugs are prescribed in very small doses. Again, the body, due to age, produces less hormones, and the processes of formation of some of them completely stop.
Effects
Much has been said above about the symptoms of lung pleurisy, treatment with folk remedies and medicines, and diagnostics. Finally, let’s say a few words about how ignoring the disease could be fraught.
The consequences are very different. The most common include:
- The appearance of adhesions and bronchopleural fistulas.
- Circulatory disorder, turning into a chronic form.
- The formation of a free cavity under the influence of accumulation of pus in the lungs.
- Pleural scarring, fraught with complete blocking of one lung.
- The formation of amyloidosis of parenchymal organs. Almost 50% of patients with this complication were fatal. But it develops in rare cases, besides only in people with weakened immunity - in children and the elderly.
It should also be noted that people who have even recovered from this disease are required to be registered with a doctor for a long time. You will also need to abandon the use of high-calorie and fortified foods, regularly carry out preventive measures, avoid hypothermia and do not work in particularly harmful conditions.