Pleurisy

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Written by Wang Chun Mei
Pulmonology
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Does pleural calcification easily turn into cancer?

Pleurisy is a very common type of inflammatory lesion clinically. There are many factors that cause pleurisy, and it is generally seen in young and middle-aged males, mainly caused by Mycobacterium tuberculosis infection of the pleural cavity. If the pleurisy is tuberculous, it is usually treated with effective anti-tuberculosis medications systematically, which typically requires a course of 6 to 9 months. After complete recovery from pleurisy, many patients may show varying degrees of calcification spots in the pleural cavity. Generally, these calcification spots after recovery from pleurisy do not easily become cancerous.

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Written by An Yong Peng
Pulmonology
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Pleurisy is caused by what?

Pleurisy is often caused by various pathogens, such as viral infections, which can lead to pleurisy termed viral pleurisy. Viral pleurisy typically presents with noticeable chest pain, and may even be accompanied by tenderness in the chest wall. Similarly, bacterial infections can also cause pleurisy. If the infection is a purulent bacterial infection, it is known as purulent pleurisy. Generally, those with purulent pleurisy experience high fever symptoms. Another common cause of pleurisy is tuberculosis infection, known as tuberculous pleurisy. Typical symptoms of tuberculous pleurisy include low-grade fever in the afternoon, night sweats, and may also include chest tightness and chest pain.

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Written by An Yong Peng
Pulmonology
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What are the symptoms of pleurisy?

Common symptoms of pleurisy include chest pain, which often worsens with deep breathing. This condition is also called pleuritic chest pain. It is important to note that the presence of such chest pain does not necessarily indicate pleurisy; it could also be due to pneumonia, pulmonary embolism, or even rib fractures. Patients with pleurisy may also experience a sensation of chest tightness, especially when there is a significant amount of pleural effusion. Furthermore, severe chest pain caused by pleurisy may lead to patients avoiding deep breaths, which can also result in symptoms of chest tightness. Fever is another common symptom in patients with pleurisy, and the severity of fever can vary depending on the infection causing the pleurisy. For example, tuberculous pleurisy, caused by tuberculosis infection, often results in a low-grade fever in the afternoon, but high fevers can also occur. In the case of purulent pleurisy, which is usually due to a bacterial infection leading to pus formation in the pleural cavity, high fevers are common.

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Written by Wang Chun Mei
Pulmonology
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What causes pleurisy in young people?

In clinical practice, populations with pleurisy are often common among young people and children. The factors inducing pleurisy in young people are mainly due to low immune function and the presence of pathogenic factors that stimulate an inflammatory response in the pleura. Such patients often experience infections, with tuberculosis infections being more common. This often leads to clinical symptoms such as chest pain, chest tightness, shortness of breath, coughing, wheezing, and even difficulty breathing. Therefore, for individuals with low immune function, it is particularly important to pay attention to strengthening nutrition and to balance work and rest. When the body's functions are weakened, it is necessary to properly enhance nutrition and exercise to improve the body's immunity and reduce the likelihood of developing pleurisy.

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Written by An Yong Peng
Pulmonology
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What are the symptoms of pleurisy?

Pleurisy often presents with symptoms of chest pain, which tends to worsen with deep breathing. Patients with pleurisy may also experience a feeling of tightness in the chest, possibly caused by a significant accumulation of fluid in the chest cavity due to the pleurisy. Sometimes, this tightness could also be due to severe chest pain that makes the patient reluctant to inhale deeply. Patients with pleurisy are likely to exhibit symptoms of fever. It is important to note that pleurisy caused by different factors may have distinct clinical features. For example, purulent pleurisy often presents with high fever, while tuberculous pleurisy may show symptoms of tuberculosis intoxication like low-grade fever in the afternoon and night sweats. However, some cases of tuberculous pleurisy might present with high fever, and others may not have noticeable fever at all. Additionally, viral pleurisy usually features prominently painful symptoms in the chest.

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Written by Wang Chun Mei
Pulmonology
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How to treat pleurisy without effusion?

Pleurisy is a very common type of inflammatory response of the pleura caused by pathogenic factors in clinical practice. In clinical settings, some patients may develop pleural effusion, while others may not. Therefore, the treatment for pleurisy without pleural effusion mainly involves symptomatic management with anti-tuberculosis drugs. Typically, the treatment with anti-tuberculosis drugs should follow a regimen that is early, combined, adequate, regular, and complete. For the treatment of such pleurisy patients, it is known that most cases are caused by infection with Mycobacterium tuberculosis. Therefore, when treating such patients, it is crucial to strictly follow the treatment regimen of anti-tuberculosis medications to effectively control the uncomfortable symptoms caused by pleurisy.

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Written by Luo Peng
Thoracic Surgery
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What medicine to take for pleurisy

Regarding what medicine to take for pleurisy, it depends on the specific actual situation. If it is simple mild pleuritis without pleural effusion and only pain, generally, if the pain is not severe, medication may not be necessary. If the pain is severe, one can (under the guidance of a doctor) take oral pain relievers like ibuprofen or acetaminophen with codeine for symptomatic treatment. If there are symptoms such as fever, coughing up phlegm, pleural effusion, or even suspected tuberculous pleuritis, long-term oral anti-tuberculosis drugs are required for treatment. If tuberculosis cannot be confirmed and there are no significant symptoms, symptomatic treatment can be administered temporarily.

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Written by Li Hu Chen
Imaging Center
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Post-pleurisy chest X-ray presentation

Patients with pleurisy, after their recovery, often exhibit certain signs on chest X-rays, such as thickening and adhesion of the pleura, and blunting of the costophrenic angle. These conditions commonly arise because diseases like pleurisy might have a somewhat extended duration or are not detected timely, lacking prompt medical treatment. Hence, pleural thickening is prone to occur, visible on X-rays at the lung margins, where localized soft tissue density appears slightly thicker. Normally, the edge of the lung at the costophrenic angle would be quite sharp, but after pleural thickening, this angle becomes blunted or even rounded. In some cases, encapsulated effusions might be seen on a chest X-ray as a spindle-shaped high-density shadow near the chest wall, which appears as a notably bright shadow.

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Written by Liu Jing Jing
Pulmonology
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Is pleurisy ascites easy to treat?

Whether pleurisy with effusion is easy to treat depends on identifying the cause of the pleurisy, which commonly includes tuberculosis, infection, and tumors. Tuberculous pleurisy can usually be cured about six months to a year after standard anti-tuberculosis treatment; infectious pleurisy generally has a good prognosis if it is sensitive to anti-infective drugs; however, pleurisy caused by tumors often indicates metastasis to the pleura, and at this stage, surgical options are no longer viable, leading to a poor prognosis. Therefore, if pleurisy is present, it is necessary to go to the hospital to complete thoracic puncture and clarify the nature of the pleural effusion, and treat according to the cause.

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Written by Yuan Qing
Pulmonology
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Sequelae of pleurisy with pulmonary effusion

The main sequelae of pleurisy with pleural effusion are pleural adhesions, which can affect respiratory function. Pleurisy is mostly caused by infectious diseases, although a portion is also due to non-infectious diseases. In the case of pleural effusion caused by infectious diseases, it contains a large amount of fibrinogen, which has the function of adhering to our pleura, thereby causing the pleura to thicken. At this time, the pleura will compress our lungs, significantly reducing the respiratory volume of our lungs, which greatly affects our respiratory function. Patients mainly exhibit symptoms such as shortness of breath, chest tightness, and rapid breathing even with slight activity or while lying in bed. Therefore, if pleurisy is detected, it is crucial to drain the fluid from the patient as soon as possible to avoid delaying treatment and the subsequent development of severe sequelae.