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Pleurisy
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.
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.
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.
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.
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.
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.
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.
Pleural inflammation CT manifestations
The causes of pleurisy mainly include tuberculous, purulent, bacterial, tumorous, traumatic, and rheumatic types, with the tuberculous type being the most common. Pleurisy is predominantly characterized by pleural effusion, which generally looks similar on a CT scan. CT scans cannot distinguish the cause of pleurisy. A small amount of pleurisy manifests as a minor amount of free effusion, appearing as an arc or crescent of uniform density along the posterior chest wall. As the effusion gradually increases to a moderate or large amount, it can compress lung tissue, leading to compressive atelectasis. In cases of large volume effusion, aside from causing atelectasis, it can also significantly push the mediastinum towards the healthy side.
The difference between pleurisy and peritonitis
Peritonitis generally refers to a severe disease caused by bacterial infection, chemical irritation, or injury, most of which are secondary peritonitis originating from infections and necrosis of abdominal organs, perforations, trauma, etc. The main symptoms include abdominal pain, tense abdominal muscles, tenderness, and board-like abdomen. Pleurisy generally refers to the inflammation of the pleura caused by pathogenic microorganisms, also known as pleuritis, which can be accompanied by pleural effusion. Pleurisy is commonly caused by tuberculosis. Generally, the symptoms of peritonitis are more severe than those of pleurisy. Both pleurisy and peritonitis require active, timely, and regular treatment.
Can pleurisy be seen on a chest X-ray?
Pleurisy can also be detected in chest radiographs, but it depends on the type. There are two types of pleurisy: dry and wet. Dry pleurisy cannot be clearly identified, while wet pleurisy, which is mostly caused by tuberculosis, can show more typical characteristics. Tuberculous pleurisy primarily manifests as pleural effusion. A small amount of pleural effusion on an X-ray appears as blunting of the costophrenic angle on the same side and blurring of the diaphragm. A moderate amount of pleural effusion is shown on the chest radiograph as a uniformly consistent high-density shadow on the same side, which appears higher on the outside and lower on the inside, with an arc-shaped shadow. The muscle costophrenic angle and diaphragm are obscured. A large amount of pleural effusion presents as a high-density shadow in the pleural cavity on the same side, with the mediastinal cardiac silhouette clearly shifting to the interlateral side.