OVERVIEW
Overview.
Tuberculous pleurisy is an inflammation of the pleura caused by the entry of Mycobacterium tuberculosis and its autolysates and metabolites into the pleural cavity of a hypersensitive organism. Tuberculous dry pleurisy is most often caused by tuberculosis spreading to the pleura, mostly in the posterior part of the lung apices, followed by the pleura of the lower chest. The manifestations are chills, fever, dry cough, chest pain, shortness of breath, and so on, and there are also people who do not have obvious manifestations. It is distinguished from common tuberculous pleurisy by the absence of pleural effusion.
Whether medical insurance
Yes
Department
Cardiothoracic Surgery, Infection, Respiratory Medicine
Clinical symptoms
Chest pain, chills, fever, dry cough, pleural friction sounds, chest pain worsens with deep breathing and coughing.
Hazards
As chest pain is aggravated by deep breathing and coughing, patients are afraid to inhale deeply, so the respiratory movement on the affected side is inhibited.
Complications
Interlobar pleurisy, mediastinal pleurisy, encapsulated effusion, lung base effusion, etc.
Examination
X-ray film, tuberculin test, erythrocyte sedimentation rate, blood routine, etc.
Diagnosis
Diagnosis can be made on the basis of history of tuberculosis, symptoms such as fever, dry cough, severe sharp pinprick-like chest pain, auscultation of pleural friction sounds, positive tuberculin test, etc.
Treatment principle
Anti-tuberculosis, analgesic and other drugs should be used to treat the cause and symptoms, and hot compresses can be applied locally.
Cure
Adequate amount and course of anti-tuberculosis treatment and regular review can lead to cure.
Dietary advice
Diet should be rich in nutrients and high in protein and vitamins.
Causes
Causes
Caused by tuberculosis spreading to the pleura.
Symptoms and Diagnosis
Typical Symptoms
Symptoms vary in severity. The onset of the disease is often characterized by chills, mild to moderate fever, and a dry cough. The main symptom is chest pain, which mostly occurs in the area of the thorax with the greatest expansion, such as the axilla on the chest side. If the lesion is in the center of the diaphragm, it may radiate to the shoulder of the same side; if it is in the peripheral part of the diaphragm, it may radiate to the upper abdominal wall and the fossa of the heart. The nature of the pain is a sharp, intense, pinprick-like pain, which is worse with deep breathing and coughing. Shallow inspiration, lying down or lying on the affected side, the expansion of the thorax is reduced, chest pain can be alleviated. Since patients with chest pain are often afraid to inhale deeply, the breathing is rapid and shallow.
Other symptoms
Localized pressure pain and decreased breath sounds. There are often limited and constant pleural friction sounds in the axillary region on the thoracic side.
Diagnostic basis
Diagnosis can be made on the basis of the history of tuberculosis, fever, dry cough, severe sharp pinprick-like chest pain, pleural friction sounds on auscultation, and positive tuberculin test.
Treatment
Treatment guidelines
Anti-tuberculosis, analgesic and other drugs should be used to treat the cause and symptoms, and hot compresses can be applied locally.
Drug treatment
Chest pain can be treated with analgesics such as codeine and analgin. Anti-tuberculosis drugs should be given.
Other treatments
Hot compresses can be applied locally for chest pain.
Prognosis
The prognosis is good with sufficient amount and course of anti-tuberculosis treatment and regular follow-up.
Nursing care
Daily care
1. Rest appropriately, exercise appropriately, pay attention to the combination of work and rest, avoid overwork. 2. Keep in a good mood, establish optimism, open-mindedness, and confidence in overcoming the disease. 3. Continue to take the medication according to the doctor’s instructions, do not stop or reduce the dose of medication. 4. Review the X-ray film regularly, and consult the doctor if there is any discomfort. 5.
Diet
Diet should be rich in nutrients, appropriate to eat high protein, vitamin-rich diet, avoid smoking and alcohol.