What are the symptoms of pleurisy and pneumothorax?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on September 05, 2024
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The pleural cavity in healthy individuals is a potential space and is under negative pressure. Its main purpose is to allow the lungs to fully adhere to the chest wall, and the lubricating fluid present serves to prevent too much friction between the lungs and chest wall during deep inhalation, which could cause pain. For various reasons, such as a ruptured lung bulla or trauma to the chest wall, a certain amount of air can enter the pleural cavity, leading to pain in patients. Due to the presence of pleurisy, friction occurs between the lungs and chest wall—particularly between the lower chest wall and the lungs—causing intense pain during deep inhalations. If a large volume of air is present, it can prevent the lungs from fully expanding, potentially leading to symptoms of breathing difficulties or an obstructed exhalation.

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Written by Wang Chun Mei
Pulmonology
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Can pleurisy cause hemoptysis?

Pleurisy, this disease in clinical practice, does not cause symptomatic hemoptysis on its own. This is because pleurisy is mainly due to bacterial invasion into the pleural cavity causing inflammatory lesions. The pleural cavity is a sealed space, which, when inflamed, often causes symptoms such as fever, cough, chest tightness, shortness of breath, and breathing difficulties when there is a significant accumulation of fluid in the chest cavity. Generally, it does not cause hemoptysis. There is only one possibility, for example, intense irritative coughing in patients with pleurisy may rupture the capillaries in the bronchial walls. In this case, patients might experience varying degrees of coughing with blood, but this is not a direct clinical symptom caused by pleurisy itself.

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Written by Yuan Qing
Pulmonology
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What should I do about pleurisy calcification?

Pleural calcification, mainly results from long-term unresolved pleuritis or inadequate timely treatment, causing adherence between the two pleural layers. Following this adhesion, calcium salts may deposit, leading to calcification. Usually, the primary consideration is whether the patient's lung function has been impacted. If so, a thoracotomy and pleural decortication might be performed to restore the pleural structure. If the patient only shows pleural calcification on imaging without significant discomfort, it may be observed without immediate intervention, and regular monitoring of the calcification is recommended to see if it enlarges. If the condition remains stable over time, it might not require treatment since this represents a tendency towards healing, or the residual scarring may not necessitate special management.

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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 Wang Chun Mei
Pulmonology
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Is it normal to occasionally feel chest tightness with pleuritis?

Patients with pleurisy occasionally experience chest tightness, which is a very common clinical symptom. It is important to clarify that in clinical cases, pleurisy is mostly due to infection of the pleural cavity by Mycobacterium tuberculosis, causing clinical symptoms such as fever, chest tightness, shortness of breath, cough, and chest pain. Therefore, during an acute episode of pleurisy, some patients may have a severe pleural infection, and possibly a large amount of pleural effusion, which inevitably leads to symptoms like shortness of breath and chest tightness. For patients with pleurisy, if it is tuberculous, it is crucial to provide anti-tuberculosis medication as early as possible for symptomatic treatment. A lengthy course of treatment is usually required to effectively control the discomfort caused by pleurisy.

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Written by Xu Jun Hui
General Surgery
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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.