Pleurisy is called inflammation of the pleura - the serous layer that envelops the lungs. The shell looks like translucent parts of the lung matter, one of which is adjacent to the lungs, and the second wraps the cavity inside. Inside there is a liquid, which guarantees the movement of the two layers of the pleura during inhalation and exhalation. Its number normally does not exceed 10 ml. With such a disease, fluid accumulates in excess.
This manifestation is often referred to as a pleural effusion. A similar form of pleurisy is called exudative or exudative. It occurs more frequently. The disease can also have a dry form - in this case, fibrin protein is deposited in the plane of the pleura, the film thickens. But, as a rule, fibrinous pleurisy is only the first stage of the disease, which precedes the subsequent formation of exudate. In addition, when the inside is infected, the exudate can also be purulent. More details about the treatment and symptoms of pleurisy in children can be found in the article.
Reasons
Pleurisy is not a primary disease. From a medical point of view, this condition can be called a complication that occurs against the background of some other diseases andpathologies. What causes pleurisy in children?
One of the most common causes is the ingestion of various microbes into the body, which, in turn, lead to the appearance of an inflammatory process of the pleural sheets. The causative agents of infections can be representatives of the specific tuberculosis flora, as well as all kinds of viruses, Haemophilus influenzae and staphylococci. The causative agents of a particular infectious disease can enter the body in various ways, for example, through contact, with lymph or blood.
Naturally, one cannot fail to mention that there is the development of infectious diseases and their subsequent complications in the form of pleurisy with increased vascular permeability, as well as against the background of a decrease in immunity. Metapneumonic pleurisy in children may appear due to frequent infections, hypothermia, as well as a lack of certain trace elements, the lack of which can affect the lungs in the most negative way. In addition, this ailment can be caused by sunstroke or mechanical damage to the chest.
Symptoms
Diagnosis of the presence of pleurisy in a small patient can be quite difficult, as the symptoms are varied. What are the symptoms of pleurisy in children?
As soon as the inflammatory process begins in the lungs, this leads to a gradual accumulation of fluid, the nature of which will depend on the stage of development of the disease, as well as on the typecausative agent of pleurisy. In addition, purulent exudate is observed with unilateral pleurisy, while serous fluid very often affects two parts of the lungs in children. However, beginning pleurisy can also be detected by other symptoms, such as persistent shortness of breath, as well as a deterioration in general condition and an increase in body temperature.
If we talk about body temperature, then it can change or remain at a certain level, in some cases such a symptom may be absent altogether. So, in children with pleurisy under the age of one year, the temperature may be at the usual level, and if its increase occurs, it will be small. It should also be noted that in very young children, all the symptoms of pleurisy may not be expressed very clearly, so specialists use special diagnostic methods.
Diagnosis
Pleurisy is inherently a secondary disease on the background of an already existing pathological process in the lungs. Therefore, taking an anamnesis of a sick child should begin with finding out the facts about the underlying diseases (eg, pneumonia, tuberculosis, rheumatism). Any diagnostic measures for exudative pleurisy in children begin with an external examination and collection of patient complaints. In case of illness, the attending physician should pay attention to painful sensations during breathing, uneven chest rise during inhalation, shortness of breath, general signs of intoxication and inflammation in the body.
To diagnose pleurisy in a child, there are specialmedical methods that will confirm the diagnosis suspected upon examination, namely:
- Complete blood count, which will give information about the number of leukocytes, accelerated erythrocyte sedimentation reaction, decrease in hemoglobin.
- X-ray and ultrasound examination for pleurisy show the presence and localization of accumulation of fluid (or air) in the pleura, and also help to determine the degree of mobility of the ribs and diaphragm, to see the degree of thickening of the inflamed pleura.
- If pathological processes were detected during X-ray examination in the pleura and lungs, a pleural puncture is necessary to obtain exudate in order to study for biochemical and bacteriological composition.
Treatment
In connection with the formation of pleurisy against the background of other diseases, its extent, signs, methods of therapy largely depend on the initial factor of the disease process in the pleura. Thus, the initial clinical recommendations for pleurisy in children are focused on eliminating the primary disease, and the therapy of the disease of interest to us is already reduced to normalizing the course of the pathology - relieving pain, normalizing the decrease in exudate, suppressing infection, normalizing respiratory function, etc.
Fixing the infection
Bacteria often become a factor in the pathology, for this reason, antibacterial treatment of pleurisy in children (antibiotic therapy) is more popular. First, as a rule, drugs are prescribed broadlyrange of action, and after receiving the results of the diagnostics to determine the infection and its susceptibility to a particular substance that is part of the drug, a certain drug is prescribed. The dose and the system of taking the substance depend on the established diagnosis and the danger of the disease process.
According to clinical guidelines, the most common medicines for pleurisy in children are as follows:
- "Ampicillin" - belong to penicillins. Influencing the wall of microorganisms, they block their reproduction. Used intravenously or intramuscularly. The daily norm is - 1.5 ml (light level), 3 ml (medium), 12 ml (severe level of the disease), but no more. Used together with Sulbactam.
- Imipenem is a beta-lactam antibacterial drug with a wide range of effects. Destroys the wall of microorganisms, initiating their death. The daily norm is 1-3 g for 2-3 doses. Used together with Cilastatin.
- "Clindamycin" blocks the protein combination of bacteria, as a result of which its growth and reproduction will be stopped. The dose intravenously and intramuscularly is 300-2700 mg per day, inside - 150-350 mg.
- "Ceftriaxone" - destroys the wall of microorganisms, initiating their death. The daily dose is 1-2 g per day intravenously or intramuscularly.
Relieve inflammation
The passage of the disease during the processes of friction of the pleural sheets among themselves is accompanied by pain. For pain reliefnon-steroidal anti-inflammatory drugs (NSAIDs) and hormones are used.
Among the substances of the NSAID category are Diclofenac, Nurofen, Nimesil, Meloxicam. The most effective glucocorticoid can be called "Prednisolone".
Detoxification
Bacteria during their presence in the body poison it with the products of their own vital activity, which are represented by toxins (poison) for humans. At the same time, dead pathogenic bacteria contribute to the development of sources of decomposition from within a person. These two conditions lead to signs of intoxication in the body, initiating loss of appetite, nausea and general malaise.
To remove dead microorganisms and toxins from living representatives of the infection, detoxification treatment is used, which contains:
- intravenous administration of glucose solutions, polysaccharides ("Dextran") and water-s alt solutions;
- use of diuretic substances (diuretics) - "Furosemide";
- use of detoxifying pharmaceutical substances – Atoxil, Albumin.
Plentiful drinking with pleurisy is not prescribed, as excess fluid will increase the volume of effusion in the pleural cavity.
Strengthening immunity
The development of infectious diseases and pathologies, as a rule, is associated with weakened immunity, since the immune system is directly responsible for the body's confrontation with pathogenic microflora. In addition, intoxication of the body with an infection in additionweakens the immune system.
To maintain the immune system, immunomodulators are prescribed - "Imudon", "IRS-19", "Timogen". Vitamin C (ascorbic acid) is considered a natural stimulant for the functioning of the immune system, a huge amount of which can be found in rose hips, cranberries, lemons, dogwoods, mountain ash, currants, viburnum.
Restoring microflora
In a good state of he alth, the human intestinal tract contains the necessary microflora - bacteria that are involved in the digestion and assimilation of food, as well as in the transformation of certain necessary elements from food and their subsequent absorption by the body.
The use of antibacterial therapy negatively affects the desired microflora, partly absorbing it. For this reason, medications are often accompanied by various secondary drugs. To restore the microflora of the intestinal tract, it is prescribed to take probiotics - Linex, Bifiform, Acipol.
Surgery
In many cases, with such a disease, a pleural puncture is made, which is also referred to as thoracocentesis. The essence of thoracocentesis is the introduction of a needle under anesthesia into the pleural cavity, through which a specific volume of water is excreted from the body. This action is carried out for two purposes - taking exudate for diagnosis, as well as removing excess exudate if the main treatment did not lead to the desired consequences, or in combination with the goal of instantaneous release of the pleural cavity. The result of this kind of manipulation for therapeutic purposes is the elimination of pressure fromlung, which improves its respiratory mobility, and in accordance with this, the patient's condition.
Eating
There are no special dietary guidelines for pleurisy. A diet is prescribed in connection with a particular disease, due to which a pathology has been created in the pleura. Nevertheless, it is possible to note that nutrition for various, especially infectious diseases, must consist of foods that are full of vitamins and microelements. This will strengthen not only the immune system, but the whole organism.
Complications
Timely treatment of pleurisy can help avoid numerous complications:
- pneumonia with pleurisy in children;
- growth of adhesions in the pleural cavity;
- obliteration of interlobar fissures;
- adhesive pleurisy;
- scarring of pleural cavities;
- compaction of the pleura;
- development of pleurosclerosis;
- empyema;
- respiratory failure;
- reducing physical activity of the diaphragm.
The presence or absence of complications is directly related to the factor in the formation of pathology.
Prevention of pathology
Preventive measures for this disease are as follows:
- timely contacting the attending doctor for various pathologies in order to get ahead of the transition of the disease into a chronic form;
- following the advice on rehabilitation after surgery on the affected area;
- try not to be in crowded places during epidemics of influenza, SARS, acute respiratory infections;
- compliance with the rules of personal hygiene;
- do not neglect rest and sleep;
- ventilate the place you are in every day;
- quit smoking and alcohol;
- avoid hypothermia.
