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, it rarely occurs separately from other ailments. It is very important to immediately pay attention to the symptoms of pleurisy and consult a doctor, otherwise you will have to deal with the consequences later. What signs indicate the presence of this disease? What causes it? How to treat it? This and many other things will be discussed now.
Reasons
Before considering the symptoms of pleurisy, it is necessary to study the reasons why this disease occurs. They can be infectious:
- Tuberculosis bacillus. According to statistics, this is a provoking factor in 20% of cases.
- Bacteria. These are usually pneumococci, staphylococci, etc.
- Parasites and protozoamicroorganisms (echinococcus, amoeba entering the body).
- Fungal infections (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 pulmonary infarction.
- Metastases in organs or malignant tumors that have arisen in the pleura.
- Pathologies of connective tissue. These are vasculitis, systemic lupus erythematosus, and rheumatoid arthritis.
- Chronic renal failure.
- Myocardial infarction.
- Other diseases (hemorrhagic diathesis, leukemia, pancreatitis, etc.).
In addition to the above, the disease may occur due to chest trauma.
Dry pleurisy
It manifests itself in reactive inflammation of the visceral and parietal pleura with the deposition of fibrin on its surface - a high-molecular protein formed from fibrinogen synthesized in the liver. The symptoms of dry pleurisy are as follows:
- Pronounced pain felt in the corresponding half of the chest with the lesion. They increase with straining, coughing, and also at the height of inspiration.
- Subsequent localization of pain in the abdominal cavity. There are signs that are similar to those of pancreatitis, appendicitis and cholecystitis.
- Dry cough.
- Common signs of inflammation, which include decreased appetite, malaise andnight sweats.
- Pain in the projection of the trapezius muscle.
- Increasing the temperature to 39°C.
- Fever with tachycardia and chills.
In especially severe cases and if the disease is ignored, pleuropericarditis may occur - an inflammatory lesion of the serous membrane of the heart. 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 a sick person, may be recovery or transition to an exudative/chronic form.
Diagnosis of dry pleurisy
It's worth briefly talking about this. To confirm the symptoms of pleurisy can only be diagnosed and a thorough examination, and several specialists. A person will have to turn to an infectious disease specialist, a rheumatologist, a pulmonologist, a gastroenterologist and a phthisiatrician. Because formal diagnosis is not enough - it is necessary to identify the cause of this disease.
Specialists resort to the following methods to detect the disease:
- Clinical blood test. With this disease, there is an increased erythrocyte sedimentation rate, as well as neutrophilic leukocytosis with a shift to the left.
- X-ray of the thoracic organs. It is usually possible to detect reduced mobility of its lower edges and a barely noticeable bulging of the lung field.
- Common urinalysis. Necessary to exclude pathological changes.
- Biochemical blood test. Symptoms of pleurisy are confirmed if it is possible to identifyincreased amount of fibrin, seromucoids, sialic acids and other acute phase indicators.
- Ultrasound. Allows you to determine if the walls of the shell are thickened and if there are layers of deposited fibrin.
- X-ray and fluoroscopy of the lungs. This method makes it possible to identify many lesions - from obliteration of the sinuses to a change in the contour of the diaphragm.
During a tactile examination, the doctor can reveal soreness and stiffness of the muscles. The doctor also fixes a weakening of breathing and an extensive or localized pleural friction rub. It occurs due to the contact of rough pleural sheets. Be sure to conduct a detailed diagnosis of the symptoms of dry pleurisy. It is impossible to prescribe treatment otherwise, since the signs of this disease are similar to some manifestations of angina pectoris, intercostal neuralgia, myositis, etc.
Treatment of dry pleurisy
If it was possible to identify the disease at an early stage, when it has not yet passed into a complicated form, then the treatment will take about two to three weeks. Therapy to eliminate the symptoms of pleurisy of the lungs is prescribed by a doctor, but, as a rule, the following drugs are prescribed to patients:
- Clindamycin. Effective bacteriostatic, the action of which is aimed at inhibiting protein synthesis, as well as the destruction of microaerophilic and anaerobic parasitic bacteria.
- III generation cephalosporins. These are powerful antibiotics with increased activity against gram-negative bacteria, also affectingPseudomonas aeruginosa and many other bacteria that adversely 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 drugs, enhancing their activity.
- Imipenem. It is a beta-lactam antibiotic that inhibits the synthesis of the bacterial cell wall, as well as destroying parasites belonging to various groups.
The listed 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 a correction of protein metabolism. To do this, a person must follow a protein diet. In especially severe cases, the doctor may prescribe the introduction of a 10% albumin solution in a volume of 150 ml and blood plasma (from 200 to 400 ml).
To reduce inflammation, the patient is prescribed steroid hormones:
- "Hydrocortisone". Suppresses the functions of tissue macrophages and leukocytes, limits 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, and anti-inflammatory effect.
Non-hormonal drugs are also prescribed. Of the most famous, Movalis, Diclofenac, Voltaren and Ibuprofen can be noted.
Prevent educationadhesions in the pleural plane are helped by procedures such as breathing exercises, vibration or classical massage, as well as physiotherapy. But the doctor will approve their conduct only after the symptoms of pleurisy of the lungs are eliminated, and the treatment can be transferred to a sparing form. Since the disease in question has a complex etiology and can be caused by tuberculosis, the patient during the course of therapy should be in a dispensary under the supervision of a phthisiatrician and undergo specific preventive treatment.
Effusion pleurisy
It is also called exudative. Before listing the symptoms of this type of pleurisy, it is worth talking about how it is formed. The disease is an inflammatory process in the lining of the lungs, accompanied by the formation of a pleural effusion - excess fluid.
In addition to the reasons already mentioned, this ailment can be formed under the influence of such factors:
- Parasitic infestations (parasite infestation).
- Drug allergies.
- Diseases accompanied by disorganization of connective tissue.
- Thermal or chemical burns.
- Uremic pleurisy (occurs when the balance of nitrogen and its compounds is disturbed in the body).
- Circulatory failure.
Symptoms of this type of lung pleurisy include:
- Clearly defined ribs in areas where fluid accumulates.
- Increased fatigue and weakness throughout the body, observed even in the absence ofphysical activity.
- Bluish tinge of the skin.
- Feeling of heaviness from localization.
- Lack of air, resulting panic.
- Acceleration of heart rate, development of arrhythmia.
- Permanent desire to lie on the affected side. So the discomfort subsides a little.
But the most dangerous symptom is the movement of the heart muscle to the he althy side. The inferior vena cava, which supplies blood to the heart, may kink. Because of this, the blood supply is disrupted, 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 a disease, then it is eliminated using other means. Above it was told about what pleurisy is and its symptoms. Healing should also be given some attention now.
Here are the procedures the patient will have to undergo:
- Taking a puncture. It is necessary both for diagnostics and for pumping out fluid. It is done once, because then adhesions form. It is quite 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 sputum discharge.
- Taking antihistamines that suppress the action of free histamine. The most popular are such medicines as "Diazolin", "Erius" and "Cetrin".
- The use of antipyretics. It's hard without themeliminate inflammation. Medsikam and Ibuprofen help best of all.
- Taking painkillers. The best drugs are Nimesil, Cefekon, Tramadol and Nise.
- Using diuretics. The most effective are "Indapamide", "Veroshpiron" and "Diakarb".
With the help of these funds, the symptoms of pleurisy of the lungs are treated in the elderly and in middle-aged patients. In especially severe cases, the doctor may prescribe glucocorticosteroids. They have a very wide range of activities. 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, ultraviolet radiation of the chest, mud wraps and paraffin applications.
Purulent pleurisy
This is the third type of disease that I would like to talk about. This disease is characterized by the 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 croup type.
Symptoms of pleurisy in adults in this case are:
- Inability to take full breaths, difficulty in this process.
- Stitching pains in the chest.
- Pronounced shortness of breath.
- Cough accompanied by phlegm, if the disease occurred after a lung abscessor pneumonia.
- Significantly increased body temperature.
- Pain in the side area.
- Severe weakness.
- Coughing attacks at night.
If you ignore the disease, then over time, fever will become a non-passing norm, and the pulse will stably keep in the range from 120 to 130 beats per minute. In the worst case, the passage of air masses and pus into the pleural cavity may occur. This is due to a ruptured lung abscess. The result is pleural shock.
Treatment of purulent pleurisy
He can't 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 functioning of diseased organs.
First of all, the doctor eliminates the purulent focus, after which he straightens the lung. Then you need to wait a little time for the pleura to grow together. After this, 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 pleura, which can provoke the transition of the disease into a chronic form.
The basis of therapy is the procedure for pumping out exudate. It is performed in parallel with 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 a very poor condition, then a surgical intervention is indicated aimed at resection of the rib.
Folk remedies
And they need to be told, since we are talking about the symptoms of pleurisy. Treatment with folk remedies can be a good concomitant therapy, but it is allowed to be carried out only after consulting a doctor, as there may be contraindications. Here are some simple and effective recipes:
- After each meal, drink 1/4 cup of freshly squeezed cherry juice with pulp.
- In equal proportions, carefully mix honey and juice squeezed 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). Cook over low heat for 40 minutes. Drink 2 scoops after each meal.
- Mix mint leaves and coltsfoot 1 teaspoon each. 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 of folk remedies for the symptoms of pleurisy of the lungs and its complications will be effective only if the person also follows medical recommendations. Be that as it may, medicines are the most effective.
In case of older patients
The symptoms and treatment of pleurisy of the lungs in the elderly must be discussed separately. It is important to state thatthey are the most vulnerable due to their age. They often have stagnant processes, and those who are forced to lead a sedentary lifestyle also have swelling of the limbs. In addition, this disease is often a consequence of arthritis, which occurs in the vast majority of overage people.
If we talk about treatment aimed at eliminating the symptoms of pleurisy in the elderly, then there will not be particularly clear differences. The only caveat is that they are prescribed hormonal drugs in very small doses. Again, the body, due to age, produces fewer hormones, and the processes for the formation of some of them stop altogether.
Consequences
A lot has been said above about the symptoms of pleurisy of the lungs, treatment with folk remedies and medicines, and diagnosis. Finally, let's say a few words about what ignoring the disease can be fraught with.
The consequences are very different. The most common include:
- Appearance of adhesions and bronchopleural fistulas.
- Circulatory failure, turning into a chronic form.
- Formation of a free cavity under the influence of accumulation of pus in the lungs.
- Scarring of the pleura, fraught with complete blockage of one lung.
- Formation of amyloidosis of parenchymal organs. Almost 50% of patients who experienced this complication ended in death. But it develops in rare cases, moreover, only in people with weakened immunity - in children and the elderly.
It should also be noted that people, eventhose cured of this disease are obliged to be registered with a doctor for a long time. You will also need to stop eating high-calorie and fortified foods, regularly carry out preventive measures, avoid hypothermia and not work in particularly harmful conditions.
