Pleurisy

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Pleurisy also called pleuritis is the inflammation of the pleura ( sac that cover the lungs which separates the lungs form chest wall,diaphragm and surrounding organs) , causes severe pain during breathing.

What causes the Pleurisy?

  •  Viral infections
  •  Secondary to pneumonia includes bacterias ,fungus
  •  Tuberculosis
  • Autoimmune diseases such as sarcoidosis
  •  Lung malignancy
  • Collagen vascular disease
  •  Trauma to lungs
  • Pulmonary embolism
  •  Gastrointestinal disease includes peritonitis, Pancreatitis
  •  Secondary to drugs ,for examples methotrexate
  • Idiopathic

What is the signs and symptoms of Pleurisy ?

  1. Sharp or stabbing pain in the chest during breathing.
  2. Shortness of breath
  3. Rapid breathing
  4. Dry or productive cough
  5. Fever with chills
  6. Sore throat
  7. Decreased appetite
  8. Loss of weight
  9. Diarrhea
  10. Pleural friction rub is present during examination

How is Pleurisy diagnosed ?

Diagnosis relies on clinical findings , radiological imaging and laboratory tests.

Radiological Imaging includes:

  1. Plain x-ray of chest : May show air or fluid in the pleural space and also used to exclude other diseases.
  2. Computed tomography(CT) scan: It helps to diagnosed primary disease like pneumonia ,tumor that causes pleurisy .
  3. Ultrasound : It may show fluid in the pleural cavity.
  4. Magnetic resonance imaging (MRI): May show fluid or primary disease in the lungs.

Laboratory tests includes:

  1. Blood tests : To identifying the type of infections ,for example bacteria, virus , fungus
  2. Thoracentesis :Take out the fluid from the plural cavity and send for laboratory tests .

How to managed Pleurisy ?

  1. Anti inflammatory drugs such as ibuprofen , naproxen to relieves the pain.
  2. Codeine to relives cough as well as pain .
  3. Oxygen in patients who feels Dyspnea.
  4. Treatment of underlying cause of the disease involves antibiotic , anti-fungal , chemotherapy , radiation therapy depend upon the types of diseases.
  5. Remove fluid form pleural cavity.
  6. If patient have tuberculosis pleurisy long term corticosteroids is needed.
  7. In some people pleurodesis ( seal of the pleural space by using drugs ) may help ,who have pleurisy due to tumors .

What is the prognosis of Pleurisy?

The prognosis depend on the severity of the underlying diseases .

References:

  • http://www.emedicinehealth.com
  • http://www.mayoclinic.com
  • http://www.medicinenet.com
  • http://www.nlm.nih.gov
  • http://en.wikipedia.org
  • Harrison’s Principles of Internal Medicine, 17th edition.
  • Davidson’s Principles and Practice of Medicine, 20th Edition

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