It is the inflammation of two layer of pleura ( Serous and Visceral layer). Between this two layers is a small space it is called pleural space that’s usually filled with a very small amount of liquid.
When the membranes become inflamed, they rub painfully against each others it cause sharp or stabbing chest pain and shortness of breath.
Pleurisy also called pleuritis.
TYPE
•• Dry pleurisy
•• With effusion
• Serofibrinous
• Purulent (Empyema)
CAUSES
• Pneumonia (most common)
• Pulmonary tuberculosis (most common)
• Bronchogenic carcinoma ( most common)
• Lung abscess ( most common)
• Lupus (SLE) (bilateral pleural effusion)
• Rheumatoid arthritis (bilateral pleural effusion)
• Mesothelioma
• Leukemia
• Lymphoma
• Amebic liver abscess
• Meige syndrome
• Viral infection
• Bacterial infection
• Fungul infection
• Rib fracture
• Sickle cell disease
• Certain medication and recreational drugs
• Rib fracture or trauma
SYMPTOMS
FOR PLEURAL EFFUSION :
• Fever evening rise of temperature
• Dysponea
• Breathlessness
• Haemoptasis
• History of chest pain
• Weakness
• Lethargy
• May have right hypochondriac pain if cause is amoebic liver disease
• Clubbing may be present due to lung abscess, bronchogenic carcinoma
• Cyanosis (Central cyanosis)
FOR ACUTE DRY PLEURISY:
• Chest pain which aggravated by deep inspiration, coughing, sneezing, or bending the chest
• Fever ( 99°f – 101°f )
• Cough without any sputum ( Dry cough)
COMPLICATIONS
• Pleural thickening
• Empyema
• Hydropneumothorax
• Cardio respiratory distress
• Lung fibrosis
INVESTIGATION
•• BLOOD:
• R/E – TC, DC, ESR
• Differential count
• Serum amylase
• Blood sugar
•• CHEST X-RAY:
• Homogenous opacity concave medially
• Obliteration of the costophrenic angle affected side
•• PLEURAL FLUID ASPIRATION ( Conformatory) :
• Nature of fluid
• Smear examination
• Culture of fluid
•• USG
•• CT SCAN
•• HRCT OF LUNG
•• BRONCHOSCOPY WITH BIOPSY
•• MANTOUX TEST
•• PLEURAL BIOPSY
•• SPUTUM FOR AVF AND CULTURE
TREATMENT
Medication –
NSAID
Analgesic
Narcotic
And depends upon cause
1.if due to bacteria antibiotics should apply
2.if due to fungal anti-fungal should apply
3.if due to virus then wait for days
Management –
Some time collection of fluid is much more than usual then your doctor may taped out through a niddle