Sequelae of pleurisy with pulmonary effusion

Written by Yuan Qing
Pulmonology
Updated on September 22, 2024
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The main sequelae of pleurisy with pleural effusion are pleural adhesions, which can affect respiratory function. Pleurisy is mostly caused by infectious diseases, although a portion is also due to non-infectious diseases. In the case of pleural effusion caused by infectious diseases, it contains a large amount of fibrinogen, which has the function of adhering to our pleura, thereby causing the pleura to thicken. At this time, the pleura will compress our lungs, significantly reducing the respiratory volume of our lungs, which greatly affects our respiratory function. Patients mainly exhibit symptoms such as shortness of breath, chest tightness, and rapid breathing even with slight activity or while lying in bed. Therefore, if pleurisy is detected, it is crucial to drain the fluid from the patient as soon as possible to avoid delaying treatment and the subsequent development of severe sequelae.

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Written by Shen Jiang Chao
Radiology
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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.

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

Pleurisy often presents with symptoms of chest pain, which tends to worsen with deep breathing. Patients with pleurisy may also experience a feeling of tightness in the chest, possibly caused by a significant accumulation of fluid in the chest cavity due to the pleurisy. Sometimes, this tightness could also be due to severe chest pain that makes the patient reluctant to inhale deeply. Patients with pleurisy are likely to exhibit symptoms of fever. It is important to note that pleurisy caused by different factors may have distinct clinical features. For example, purulent pleurisy often presents with high fever, while tuberculous pleurisy may show symptoms of tuberculosis intoxication like low-grade fever in the afternoon and night sweats. However, some cases of tuberculous pleurisy might present with high fever, and others may not have noticeable fever at all. Additionally, viral pleurisy usually features prominently painful symptoms in the chest.

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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 Yuan Qing
Pulmonology
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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.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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What are the symptoms of pleurisy and pneumothorax?

The pleural cavity in healthy individuals is a potential space and is under negative pressure. Its main purpose is to allow the lungs to fully adhere to the chest wall, and the lubricating fluid present serves to prevent too much friction between the lungs and chest wall during deep inhalation, which could cause pain. For various reasons, such as a ruptured lung bulla or trauma to the chest wall, a certain amount of air can enter the pleural cavity, leading to pain in patients. Due to the presence of pleurisy, friction occurs between the lungs and chest wall—particularly between the lower chest wall and the lungs—causing intense pain during deep inhalations. If a large volume of air is present, it can prevent the lungs from fully expanding, potentially leading to symptoms of breathing difficulties or an obstructed exhalation.