-IBIS-1.5.0-
tx
respiratory system
pleurisy
diagnoses

definition and etiology

definition:
Inflammation of the pleura of the lungs.

etiology:
• Pleural injury due to pathology in the lung: e.g. pneumonia, embolism.
• Invasion of pleural space by an infectious agent.
• Invasion of the pleura by an infectious or noxious agent via the blood-stream or lymphatics.
• Pleural trauma.
• Pleural inflammation due to asbestos.
• Pleural effusion due to chronic ingestion of dantrolene sodium

signs and symptoms

signs and symptoms:
The onset is typically sudden.
• Pain: worse breathing, coughing.
• Breathing is shallow and rapid.
• (+) pleural friction rub upon auscultation: often heard only after the pain has been present 24-36 hours; is pathognomonic for pleurisy.
• Effusion: with effusion, the pain generally disappears; percussive dullness; absent tactile fremitus; minimal or absent breath sounds; (+) egophony; possible dyspnea.

lab findings:
• (+) x-ray.
• (+) Needle biopsy for effusion.
• Total and differentiated cell counts: to identify condition.

course and prognosis

Fibrosis of the pleura may occur as part of the healing reaction. Though usually minimal, it may encase the lung with fibrous tissue decreasing chest wall motion and causing pulmonary dysfunction. Conventional treatment consists of wrapping the chest, bronchial lavage, thoracentesis (if effusion is present), parenteral antibiotics (with empyema), or enzymes (with hemothorax).

differential diagnosis

• Heart attack.
• Spontaneous pneumothorax.
• Pericarditis.
• Chest wall lesions.
• Costochondritis.
• Acute abdominal distress.
• Intercostal neuritis.
• Embolic phenomena.
• Pneumonia.


footnotes