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 (croupous) pneumonia. In the course of this disease, a specific plaque appears on the surface of the pleural sheets. Another reason 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 there is no light exudate in the pleural cavity, which contains a certain amount of fibrin. As a result, the accumulated fluid washes the pleural sheets, after which fibrinous plaque accumulates, which increases the thickness of the pleural wall. In the future, there is a process of replacing the walls of the pleura itself 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, causing the infected person to cough.
Etiology of the phenomenon
If any inflammatory process occurs in the body, then there is a risk of pleurisy, especially patients whose inflammatory processes occur directly in the lungs or in organs located near the pleura are susceptible to this disease. 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 striking example is lupus erythematosus or uremia, which developed as a result of kidney failure. As a rule, with uremia, nitrogenous scales accumulate on the pleural sheets, and those, in turn, irritate the walls of the pleura.
Septic diseases, that is, infectious, include: SARS, lung abscess, tuberculosis and pneumonia of all types.
People are susceptible to this disease if:
- Constantly in a nervous state.
- They endure frequent cooling due to their profession.
- Overwork.
- Prone to severe chemical tolerance.
- Do not support a he althy lifestyle.
Symptomatic manifestations
A reliable auscultatory sign of fibrinous pleurisy is friction in the pleura, characteristic of this disease. Sometimes this sound resembles the crunch of dry snow. In addition, its brightest signs are: painful, dry, severe cough, pain in the chest or even hiccups. Furthermore,patients suffer from high fever or chills, there is shallow breathing, weakness and sweating. On an x-ray with fibrinous pleurisy, a bright lag in breathing is tracked from the affected side. In medical practice, the most difficult and main task is to timely distinguish pleurisy from a fracture of the ribs or from intercostal neuralgia.
Stages of pathology
Fibrinous pleurisy is a response of the body to foreign bodies (germs) that develops in three stages:
- At the first stage, the blood vessels of an infected person dilate. They are easily permeable and prone to various damages. As a result, the amount of accumulated fluid increases dramatically.
- The second stage is characterized by the formation of a purulent mass, so the pathology gradually develops. Certain deposits, which are known as fibrin deposits, create friction on the sheets of the pleura during the patient's breathing. The pleural cavity is filled with pockets and adhesions. All this violates the decrease in exudate. In general, the outcome of all of the above is a purulent formation.
- The third stage is the process of the patient's recovery, all the disorders that have occurred in the body gradually return to normal thanks to medications and various procedures. However, the disease does not leave the patient's body - it goes into a chronic stage and hides in the body, but often does not manifest itself in any way in the future. A person becomes much better, although at the same time the infection is called completely defeatedcan't.
Parapneumonic left-sided fibrinous pleurisy
A striking feature of this disease is intrapulmonary left-sided unusual inflammation, which was confirmed by X-ray. This inflammation is characterized by a sharp regression during antibiotic therapy. Treatment does not take a long period, in the early stages the disease is easily treatable.
Serous
Serous-fibrinous pleurisy is detected in the course of damage to the nodes of the mediastinum and lymph nodes. Tuberculosis is the main cause, the source for the manifestation of this disease. Allergic process, perifocal inflammation and tuberculous lesion of the pleura are the three most important factors for the development of pathology. In its signs, it resembles ordinary pleurisy. This is a consequence of 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 fever, syphilis, diphtheria and periarteritis nodosa.
Based on the location of the tumor itself, there are diaphragmatic, mediastinal (posterior, anterior, left lateral, right, etc.), parietal (cloak-like, interlobar) types.
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 severe. Pathogens can provoke pleurisy in the aggregate and singly. The basis for this disease is staphylococcal destruction of the lungs. Moreover, another focus of this disease are ruptures of the esophagus. With such a pathology, scarring of the pleura 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 an acute purulent pleurisy, and later 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 causative agents of this disease. Residents of rural areas are at particular risk of infection, as there are the most optimal conditions for the reproduction and survival of viruses. When the causative agents of tuberculosis enter an uninfected area (in addition to the lungs, there are also skin, bones, lymph nodes, etc.), they begin to multiply, which leads to serious consequences. Soon, bumps are formed in the zone of inflammation, which 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 difficult tasks on the way to recovery is the correct diagnosis of the disease. The most common way to detect pleurisy is considered to be an x-ray.
Complete blood count reveals leukocytosis, increased ESR or anemia. In addition, urinalysis shows the presence of epithelium or red blood cells. Contenttotal protein, as well as foreign bodies (fibrinogen or sialic acids) is determined by a biochemical blood test.
Fibrinous-purulent pleurisy can be detected using a micropreparation. A micropreparation is a glass slide on which the unit under study is placed. Using a microscope, objects of infected zones are examined. Fibrinous-purulent pleurisy is shown below on a demonstration micropreparation.
Principles of treatment
Given that pleurisy is a secondary disease, it should be treated in parallel with the underlying cause. Therapy needs to be comprehensive. The goal of treating fibrinous pleurisy is to relieve the patient's pain and eliminate the tumor as soon as possible. And in the future, all measures are taken to eliminate complications.
The treatment itself includes medication, often strong antibiotics. In no case should ancillary procedures such as physiotherapy or pleural puncture be avoided or abandoned. The general course of treatment includes:
- Medicines that reduce pain.
- Medicines with warming properties.
- Cough-reducing drugs.
It must be borne in mind that the placement of the 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 againstuse any folk remedies and avoid self-treatment at home, as activities of this kind lead to irreversible consequences that seriously affect the patient's well-being.
During the course of the disease, the attending physician prescribes a special diet, which is high in protein and almost completely lacks liquid.
Another necessary condition for the recovery of the patient are the usual walks in the fresh air and massages. In order to avoid the spread of pathogenic microorganisms, such activities should be carried out during the rehabilitation period.
Possible Complications
Despite the fact that fibrinous pleurisy itself is a complication after other pulmonary diseases, certain complications may arise in conditions of illiterate or unstable treatment. These include:
- Development of adhesive process in the pleural cavity.
- Pleurosclerosis.
- Increased pleural sheets.
- Extended lines.
- Immobility of the diaphragmatic dome.
- Respiratory failure.
Another important point may be the property of the inflamed pleura to fuse with other organs, such as the heart, which sometimes even with surgical intervention causes serious damage to he alth and causes serious consequences.
Rehab
Even after completely getting rid of this disease, you should visit sanatoriums for the first 2-3 years. If treatmentwas carried out correctly and all the necessary procedures were performed, then complications should not arise. In case of delayed initiation of therapy or weak immunity, valvular pneumothorax may occur. However, its treatment is not difficult, and it manifests itself extremely rarely.
In conclusion, one cannot but recall that fibrinous pleurisy is a serious disease. It cannot resolve itself, so attempts to treat it on your own, without experienced specialists, only worsen the patient's well-being. As a result, sooner or later he ends up in the hospital anyway, but the disease is already too advanced by this time. Unfortunately, in medical practice, cases of death are known, but they occurred decades earlier, and even then very rarely. You should pay more attention to your he alth and contact specialists with the slightest change in well-being.
