Pleurisy is an inflammatory disease of the pleura that occurs due to the deposition of fibrin on its surface or the accumulation of fluid inside the pleural cavity, with coughing and pain during breathing. The causes of this disease can be several. In the first place, it can be caused by infectious agents of a viral or bacterial nature, as well as parasites and fungi. Pleurisy, the treatment of which is quite complicated, most often develops on the basis of pneumonia, tuberculosis or lung abscess. In addition, it can cause some non-communicable diseases and pathological conditions, for example, systemic diseases, malignant tumors, chest injuries and operations, diseases of the digestive tract, myocardial infarction, systemic vasculitis and others.
Pleurisy is diagnosed, the treatment of which is carried out only after that, on the basis of the clinical picture of the disease, with the obligatory consideration of the results of instrumental diagnostics, consisting of radiography and computed tomography, thoracoscopy, pleural puncture and ultrasound examination. A general analysis of blood, urine, as well as a study of the pleural contents can also be used. Differential diagnosis is performed with angina pectoris, pericarditis, myocardial infarction, acute appendicitis, intercostal neuralgia, acute cholecystitis, pleural empyema, spontaneous pneumothorax and gastric ulcer.
Pleurisy: treatment depending on the nature of the disease
If pleurisy is of an infectious nature, then the pathogen usually penetrates in some way into the pleural cavity, causing inflammation. The result is an increase in the permeability of blood capillaries, due to which pleural edema begins, and then exudation into the pleural cavity occurs. The liquid part is absorbed through the lymphatic vessels, and fibrin is deposited on the pleural sheets, forming dry pleurisy. In this case, it is paramount to get rid of the infection through antibiotics.
There is another option for the development of the disease. In the case of an increased intensity of the inflammatory process, as well as during the closure of lymphatic vessels, the rate of exudation prevails over the rate of absorption, due to which the exudate accumulates in the pleural cavity, forming osmotic pleurisy. In this case, in addition to taking antibiotics, the patient is prescribed special procedures to extract exudate.
The occurrence of non-infectious pleurisy is associated with the effects of the products of the exchange of neoplasms on the pleural sheets, while the lymphatic vessels are clogged due to compression by the tumors or their metastases, after which the lymph movement is disturbed. In this case, the most effective treatment is to get rid of the disease that caused pleurisy. At the same time, the condition of the patient is facilitated by the appointment of special drugs.
Pleurisy: treatment depending on the clinical picture of the disease
The clinical picture of dry pleurisy can be characterized by fever, general weakness, pain in the chest, muscles and joints. When taking deep breaths, sharp pain may appear in the chest area, also when tilting the body or during coughing. During a clinical examination of a patient with dry pleurisy, surface respiration, partial lag in the respiratory act of the affected part of the chest, and the sound of friction of the pleura can be detected. If we are talking about exudative pleurisy, then there is an increase in temperature, as well as a feeling of heaviness in the chest, shortness of breath, dry cough, increased sweating. Blueness of the skin of the neck and face, swelling of veins on the neck, and an increase in the affected side of the chest are noted. This is only part of the symptoms that pleurisy can accompany.
The treatment of this disease is carried out exclusively in the hospital after the causes of the disease are established. The complex treatment of pleurisy includes:
- antibiotic therapy, if the disease is associated with an infection, in other situations, targeted chemotherapy is carried out;
- if the disease developed on the background of pneumonia, then broad-spectrum antibiotics are used. Their input is carried out intravenously, intramuscularly;
- the pleural cavity must be cleaned of effusion, it is used for this washing with special antimicrobial agents;
- if pleurisy is rheumatic or tuberculous in nature, then it is very effective to use prednisone, streptomycin, tubazide, phtivazide and PASK;
- therapeutic methods are used to strengthen the protective-immunobiological functions.
Herbal medicine is often used in combination with other treatments. However, before taking this or that collection, you need to familiarize yourself with its contraindications.
In the treatment of pleurisy, an important point is the treatment of the underlying disease, which became the cause of this disease. With dry pleurisy, pain can be relieved by bandaging the chest with elastic bandages. In this case, the patient is prescribed anti-inflammatory drugs that significantly facilitate the course of the disease.