Pathophysiology and Etiology
- Secondary occur as a result of the primary causes such as pneumonia (bacterial or viral), pulmonary embolism, pulmonary tuberculosis, bronchiectasis.
- Associated with rib fractures and thoracic wall.
- Irritation that comes from below the diaphragm: hepatitis or abscess subfrenik.
- Pleurodinia epidemic (Bornholm disease, devil's grippe).
- Pleurodinia epidemics such as "lupus erythematosus"
- Inflammation of the pleura with fibrineus exudate can lead to pleural adhesions.
Pleurisy Symtomps
- Complaints and symptoms according to the basic disease, such as pneumonia, pulmonary infarction, but the protruding chest pain.
- Chest pain like being stabbed associated with inspiration and expiration.
- Breathing becomes shallow and rapid.
- Because of pain, reduced chest expansion on the sore area and decreased breath sounds.
- Pleural friction sound can be heard on breathing in, especially on the "dry pleurisy".
- Dry cough is ineffective and accompanied by pain.
- Febrile and malaise.
Physical examination
- Chest wall can mencembung due to pleural effusion. If you already have pencembungan chest pain usually lessens. Percussion sounds overcast condition on the sore area and decreased breath sounds on auscultation until it disappears.
- "Pleural friction rub" that is, pleural friction sound may be heard through a stethoscope during respiration.
- Where the string sound in sync with the systolic and strengthened in time breathing the possibility of friction noise coming from the pleuro-pericardial.
Chest X-Ray Photo.
- Chest X-Ray image is important to look for basic illnesses such as lung tumors, pulmonary tuberculosis, pneumonia and effusion.
- Normal chest X-Ray photos, and chest pain possible "dry pleurisy".
- But the normal chest image, can not rule out the possibility of lung disease as the cause pleurisy.
Pleural puncture to aid the diagnosis by microscopic examination and culturing.
Diagnosis
- Pleurisy diagnosis can be enforced, if the patient complained of pleuritic pain or a pleural friction sound.
- Typical signs of pleural pain is pain like being stabbed with a knife (sharp pain) and increased pain when the patient breathe deeply or cough.
Differential Diagnosis
- Herpes zooster
- Fracture rib
- Non-rheumatic disorders such as fibrositis artikuler
- Pericarditis
- Pneumothorax.
Management of pleurisy
- Analgesics such as antalgin can be given according to need. In severe pleuritic pain may be given pethidine 100 mg im or morphine 10 mg i.m.
- Antibiotics or chemo-terapeutic for basic illnesses.
- The rib fractures, chest bandage.
- See also pleural effusion.
Prognosis
- Depending on the basic disease and is usually cured by treating the basic disease.
- Can be a "Chronic Adhesive Pleurisy" that interfere with lung physiology.
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