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Pleurisy
Pleural inflammation CT manifestations
The causes of pleurisy mainly include tuberculous, purulent, bacterial, tumorous, traumatic, and rheumatic types, with the tuberculous type being the most common. Pleurisy is predominantly characterized by pleural effusion, which generally looks similar on a CT scan. CT scans cannot distinguish the cause of pleurisy. A small amount of pleurisy manifests as a minor amount of free effusion, appearing as an arc or crescent of uniform density along the posterior chest wall. As the effusion gradually increases to a moderate or large amount, it can compress lung tissue, leading to compressive atelectasis. In cases of large volume effusion, aside from causing atelectasis, it can also significantly push the mediastinum towards the healthy side.
The difference between pleurisy and peritonitis
Peritonitis generally refers to a severe disease caused by bacterial infection, chemical irritation, or injury, most of which are secondary peritonitis originating from infections and necrosis of abdominal organs, perforations, trauma, etc. The main symptoms include abdominal pain, tense abdominal muscles, tenderness, and board-like abdomen. Pleurisy generally refers to the inflammation of the pleura caused by pathogenic microorganisms, also known as pleuritis, which can be accompanied by pleural effusion. Pleurisy is commonly caused by tuberculosis. Generally, the symptoms of peritonitis are more severe than those of pleurisy. Both pleurisy and peritonitis require active, timely, and regular treatment.
Can pleurisy be seen on a chest X-ray?
Pleurisy can also be detected in chest radiographs, but it depends on the type. There are two types of pleurisy: dry and wet. Dry pleurisy cannot be clearly identified, while wet pleurisy, which is mostly caused by tuberculosis, can show more typical characteristics. Tuberculous pleurisy primarily manifests as pleural effusion. A small amount of pleural effusion on an X-ray appears as blunting of the costophrenic angle on the same side and blurring of the diaphragm. A moderate amount of pleural effusion is shown on the chest radiograph as a uniformly consistent high-density shadow on the same side, which appears higher on the outside and lower on the inside, with an arc-shaped shadow. The muscle costophrenic angle and diaphragm are obscured. A large amount of pleural effusion presents as a high-density shadow in the pleural cavity on the same side, with the mediastinal cardiac silhouette clearly shifting to the interlateral side.
Can pleurisy cause hemoptysis?
Pleurisy, this disease in clinical practice, does not cause symptomatic hemoptysis on its own. This is because pleurisy is mainly due to bacterial invasion into the pleural cavity causing inflammatory lesions. The pleural cavity is a sealed space, which, when inflamed, often causes symptoms such as fever, cough, chest tightness, shortness of breath, and breathing difficulties when there is a significant accumulation of fluid in the chest cavity. Generally, it does not cause hemoptysis. There is only one possibility, for example, intense irritative coughing in patients with pleurisy may rupture the capillaries in the bronchial walls. In this case, patients might experience varying degrees of coughing with blood, but this is not a direct clinical symptom caused by pleurisy itself.
Is it normal to occasionally have chest pain with pleurisy?
Pleurisy is a very common type of disease, with many triggering factors. Most cases of pleurisy are caused by infection of the pleural cavity by Mycobacterium tuberculosis, leading to inflammatory lesions. Once pleurisy is diagnosed, patients should promptly receive anti-tuberculosis medication for effective treatment. It is commonly known that if pleurisy is not controlled promptly and effectively, it may lead to worsening symptoms such as cough, fever, shortness of breath, chest tightness, and chest pain, so these clinical symptoms are also very common in patients with pleurisy. Therefore, it is very common for patients with pleurisy to experience chest pain. Even after complete recovery from pleurisy, there may be varying degrees of chest pain, which is considered normal. This is because pleurisy in the acute phase may involve different degrees of adhesions, hence chest pain may occur later on as well.
What is the cause of hemoptysis in pleurisy?
Pleurisy is generally more commonly seen in young adults and children clinically, and is most commonly caused by an infection of the pleura by Mycobacterium tuberculosis. Usually, patients with this type of pleurisy do not experience symptoms of coughing up blood. The typical symptoms caused by pleurisy primarily include chest pain, coughing, chest tightness, shortness of breath, and in severe cases with a lot of pleural effusion, it can cause the patient to experience breathing difficulties and sometimes chills. Therefore, the clinical symptoms presented by different patients can vary. When a patient with pleurisy has a severe cough, it can lead to the rupture of the capillaries in the bronchial walls, which can cause the patient to have varying degrees of blood in the sputum, or even coughing up blood.
Is pleurisy serious in young people?
Pleurisy, when it occurs in young people, is also relatively common in clinical settings. It is primarily caused by an invasion of the pleura by Mycobacterium tuberculosis, resulting in an inflammatory lesion. The symptoms manifested by these patients mainly include coughing, shortness of breath, chest tightness, chest pain, and in severe cases, respiratory difficulties. Tuberculous pleurisy is mostly seen in adolescents and children. If young people are diagnosed with pleurisy and receive timely and accurate diagnosis, along with systematic and effective treatment with anti-tuberculosis drugs, their condition can generally be effectively controlled. However, it is important to note that although young people have better resistance, they must strictly adhere to the treatment duration for anti-tuberculosis medication, which usually spans six to nine months to completely cure pleurisy.
Is pleurisy calcification dangerous?
Pleural calcification generally poses no major danger. It is typically a result of incomplete treatment of pleuritis or prolonged illness that delays the disease management, causing the disease to progress and the pleura to develop adhesions, leading to the deposition of calcium salts on the pleura and resulting in calcification. Depending on the extent of this pleural calcification, if severe, it may affect lung expansion and thereby reduce respiratory function. However, most cases do not exhibit significant symptoms. Moreover, it does not greatly impact the patient's life or quality of life. Therefore, when such calcification is observed, it is generally recommended that the patient be advised to attend regular follow-up checks. It does not necessarily cause any special symptoms, so there is no need for concern.
Is it normal to occasionally feel chest tightness with pleuritis?
Patients with pleurisy occasionally experience chest tightness, which is a very common clinical symptom. It is important to clarify that in clinical cases, pleurisy is mostly due to infection of the pleural cavity by Mycobacterium tuberculosis, causing clinical symptoms such as fever, chest tightness, shortness of breath, cough, and chest pain. Therefore, during an acute episode of pleurisy, some patients may have a severe pleural infection, and possibly a large amount of pleural effusion, which inevitably leads to symptoms like shortness of breath and chest tightness. For patients with pleurisy, if it is tuberculous, it is crucial to provide anti-tuberculosis medication as early as possible for symptomatic treatment. A lengthy course of treatment is usually required to effectively control the discomfort caused by pleurisy.
Does pleurisy cause chest pain?
Pleurisy can cause anterior chest pain. It is a very common clinical disease, mostly caused by bacterial invasion of the pleura resulting in inflammatory lesions, with Mycobacterium tuberculosis being the most common pathogen. Due to inflammatory exudation, some patients may also experience varying degrees of pleural effusion. The clinical symptoms presented by patients mainly include fever, cough, shortness of breath, chest tightness, and chest pain. In severe cases, different levels of breathing difficulties and other clinical symptoms may occur. Therefore, it is very common for patients with pleurisy to experience anterior chest pain.