What is the cause of hemoptysis in pleurisy?

Written by Wang Chun Mei
Pulmonology
Updated on September 09, 2024
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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.

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Written by Shen Jiang Chao
Radiology
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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.

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Written by Wang Chun Mei
Pulmonology
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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.

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Written by An Yong Peng
Pulmonology
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Pleurisy is caused by what?

Pleurisy is often caused by various pathogens, such as viral infections, which can lead to pleurisy termed viral pleurisy. Viral pleurisy typically presents with noticeable chest pain, and may even be accompanied by tenderness in the chest wall. Similarly, bacterial infections can also cause pleurisy. If the infection is a purulent bacterial infection, it is known as purulent pleurisy. Generally, those with purulent pleurisy experience high fever symptoms. Another common cause of pleurisy is tuberculosis infection, known as tuberculous pleurisy. Typical symptoms of tuberculous pleurisy include low-grade fever in the afternoon, night sweats, and may also include chest tightness and chest pain.

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Written by Liu Jing Jing
Pulmonology
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Is pleurisy ascites easy to treat?

Whether pleurisy with effusion is easy to treat depends on identifying the cause of the pleurisy, which commonly includes tuberculosis, infection, and tumors. Tuberculous pleurisy can usually be cured about six months to a year after standard anti-tuberculosis treatment; infectious pleurisy generally has a good prognosis if it is sensitive to anti-infective drugs; however, pleurisy caused by tumors often indicates metastasis to the pleura, and at this stage, surgical options are no longer viable, leading to a poor prognosis. Therefore, if pleurisy is present, it is necessary to go to the hospital to complete thoracic puncture and clarify the nature of the pleural effusion, and treat according to the cause.

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Written by An Yong Peng
Pulmonology
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What are the symptoms of pleurisy?

Common symptoms of pleurisy include chest pain, which often worsens with deep breathing. This condition is also called pleuritic chest pain. It is important to note that the presence of such chest pain does not necessarily indicate pleurisy; it could also be due to pneumonia, pulmonary embolism, or even rib fractures. Patients with pleurisy may also experience a sensation of chest tightness, especially when there is a significant amount of pleural effusion. Furthermore, severe chest pain caused by pleurisy may lead to patients avoiding deep breaths, which can also result in symptoms of chest tightness. Fever is another common symptom in patients with pleurisy, and the severity of fever can vary depending on the infection causing the pleurisy. For example, tuberculous pleurisy, caused by tuberculosis infection, often results in a low-grade fever in the afternoon, but high fevers can also occur. In the case of purulent pleurisy, which is usually due to a bacterial infection leading to pus formation in the pleural cavity, high fevers are common.