Dry and exudative pleurisy

Pleuritis is called inflammatory disease of the pleura leaves with deposition of fibrin on their surface (dry pleurisy) or accumulation of fluid in the pleural cavity (exudative pleurisy). This is not an independent disease, it develops as a complication of the pathological process in the lungs, mediastinum, chest. This disease is often a manifestation of tuberculosis, rheumatism, diffuse collagen and cancer.

In pleurisy, the infection enters the pleural cavity in various ways: contact, lymphogenically, hematogenically and with open trauma, wounds, surgical interventions.

In the clinic of these diseases several syndromes are distinguished:

• Inflammation of the pleura;
• Collecting fluid in the pleural cavity;
• Inflammation;
• Intoxication.

Dry pleurisy

The disease begins acutely with the appearance of pain in the chest, which is intensified with deep breathing, coughing, and movements of the trunk. The patient, trying to protect a sore spot, tries to lie on a healthy side. Breathing is frequent, superficial. A dry, unproductive cough is characteristic, which is aggravated by movement.

The clinical course of dry pleurisy is predominantly mild. The disease lasts two to three weeks and depends on the course of the underlying disease. Prolonged relapsing dry pleurisy is characteristic for the tuberculosis process, which requires prolonged specific treatment.

Excessive pleurisy

Exudative pleurisy can be a continuation of dry or complication of another disease. The nature of the exudate depends on the severity of the disease and the cause of pleurisy. For example, bloody exudates occur with lung cancer, metastases, tuberculosis, lung infarction; Serous and serous-fibrinous - with rheumatism, tuberculosis, chronic renal failure, collagenoses.

In the clinical course of exudative or effusive pleurisy there are three phases: accumulation of exudate, its stabilization and resorption. Occasional pleural effusion develops, which may have different localization.

Exudative pleurisy can develop acutely and gradually. In acute course , body temperature rises rapidly , chills appear, pain in the chest area from the side of the lesion, dry cough, shortness of breath, severe weakness. With the appearance of effusion, the pain gradually decreases, but dyspnea increases and becomes noticeable even at rest.

An intensive homogenous darkening in the place of accumulation of exudate is determined during X-ray examination.

Treatment of pleurisy

In the case of dry pleurisy, the primary disease is treated primarily. In the tuberculosis process, specific antituberculous drugs are prescribed. If dry pleurisy is caused by pneumonia, antibiotics are prescribed. With anti-inflammatory, salicylates and non-steroidal anti-inflammatory drugs are prescribed. For analgesia, analgesics are used. The indications are glucocorticoids, detoxification and desensitizing therapy. In the early stages of dry pleurisy, electrophoresis is used. With a decrease in acute manifestations of the disease, massage and thermal physiotherapy procedures are indicated.

If exudative pleurisy is diagnosed, the main method of therapy is pleural puncture. After the puncture, the treatment of exudative or exudative pleurisy is carried out in the same way as the dry one. With a reduction in the inflammatory process and no signs of reassembling fluid in the cavity, a resorption therapy is prescribed.

Usually the pleurisy is favorable, but can be protracted. Exceptions are pleural inflammation in cancer and systemic diseases. Exudative pleurisy is more severe than dry. After convalescence, adhesions, thickening of pleura sheets, and the development of heart failure may remain.