Pleurisy (pleurisy) – causes, complaints & therapy

The pleura, which is composed of the pleura and the pleura, is a thin layer of tissue that lines the chest internally and covers the lungs.

The pleura is the inner lining of the chest and the covering of the pericardium and diaphragm.

Both components of the pleura, the pleura and the pleura, lie on top of each other and, with the help of a thin layer of moisture, ensure that the lungs can cling to the chest, but still remain mobile.

A distinction is made between dry and wet pleurisy. Dry pleurisy leads to rubbing of the lungs on the chest. In the moist variant, fluid accumulates between the lungs and ribs.

Causes

The cause of pleurisy or pleurisy is usually another source of infection that spreads to the pleura. Here, severe tuberculosis can be the trigger as well as pneumonia or a lung infarction.The previous infectious disease may have been caused by bacteria, in rare cases also by viruses (herpes) or fungi.

Furthermore, pleurisy can also have non-infectious causes. On the one hand, various tumor diseases can lead to pleurisy. Examples include bronchial carcinoma and a tumor of the pleura.

Furthermore, rheumatic diseases, autoimmune diseases (lupus erythematosus) or pulmonary embolism can also cause pleurisy.

Symptoms and course

The primary symptom of dry pleurisy is the painful chest that occurs in connection with breathing. This pain can occur not only on both sides of the chest, but also on the front or back.

Another typical sign of dry pleurisy is the so-called leather creaking of the rib and chest skins rubbing against each other during breathing. Furthermore, it comes to a low-expectation cough. Moist pleurisy is characterized by a feeling of pressure on the chest. The strength of this feeling depends on the amount of fluid accumulated. This can even lead to shortness of breath.

Another symptom of wet pleurisy can be shoulder pain. These are caused by the irritation of the diaphragmatic nerve by the effusion. If pleurisy is treated early, a cure can be expected soon.

However, in more severe cases, pleurisy can lead to various complications. Particularly serious is the merging of the lung with the ripple membrane. As a result, the lungs are firmly connected to the chest and can no longer unfold freely. Breathing is severely restricted by this complication and the affected person no longer gets enough air.

Diagnosis

Pleurisy can have various causes, so the diagnosis is made in several steps. As part of the anamnesis, the doctor asks about previous diseases such as pneumonia or tuberculosis and what treatment was given. In addition, he has the complaints described, which can manifest themselves in pain during breathing or shortness of breath.

Often it is recognizable from the patient’s posture that something is wrong. As part of the physical examination, he listens to the patients. In the presence of pleurisy, a creaking noise is audible. Then the chest is tapped.

An X-ray examination is essential for diagnosis. If the pleurisy is dry, the X-ray is unremarkable. If the aim is to make accumulations of liquid visible, an ultrasound examination or computed tomography can be helpful in making a diagnosis. At the same time, the imaging diagnostic methods provide information about the cause of the pleurisy.

To determine whether certain pathogens are the cause of the inflammation, the doctor can use a puncture needle to take a sample of the fluid in the pleural space. The fluid taken is subjected to a laboratory test to find clues to the causative agent of the disease. Sometimes a thoracoscopy can be useful. During this examination, the doctor inserts an endoscope through a small hole in the chest wall. So he can see the chest cavity from the inside.

treatment and therapy

Pleurisy should be treated as early as possible to avoid such complications. The aim of therapy is primarily to treat the underlying disease.

It is also important that the affected person continues to breathe deeply and move their lungs to prevent the pleura from growing together. This can be done with special breathing exercises. But painkillers that make breathing easier also support deep breathing.

Medication that inhibits the urge to cough can be used to counteract the painful, dry cough caused by dry pleurisy .

If the pleura has already grown together, an operation may be necessary to restore the mobility of the lungs. In the case of wet pleurisy, the fluid can be drained. Rinsing the pleura with antibiotics can also facilitate healing.

Prevention

There are no direct preventive measures to prevent pleurisy. However, boosting your immune system, eating a healthy diet, and exercising in fresh air can help prevent pleurisy. Furthermore, respiratory infections should be avoided as far as possible so that they cannot spread to the pleura. There are no other options or vaccination to prevent pleurisy.