Pleurisy as a Secondary Disease

Pleurisy can occur as a consequence of various diseases and is not contagious. A distinction is made between dry and moist pleurisy, which are characterized by different symptoms. If such an inflammation is not treated in time, pus may form and surgery may become necessary. Read everything about signs, course and therapy of pleurisy here.

What is pleurisy?

The pleura – the pleura – is a fine skin that surrounds the lungs (pleura) and lines the chest (pleura). Between them is a small gap filled with a small amount of fluid (pleural space). The fluid ensures that the lung pleura and the pleura can slide smoothly past each other during inhalation and exhalation. In pleurisy, which can occur regardless of age, these two protective membranes are inflamed.

Possible causes of pleurisy

Pleurisy is not contagious and most often occurs as a secondary disease. The following conditions are possible underlying causes:

  • A pneumonia with transfer of pathogens to the pleura.
  • An acute bronchitis
  • Lung cancer
  • A pulmonary embolism
  • Tuberculosis
  • Diseases of adjacent organs in the abdominal cavity and pelvis (for example, inflammation of the renal pelvis).

Pathogens – often bacteria and only rarely viruses – originating from distant sites of inflammation can also be the cause of pleurisy.

Pleurisy: symptoms

Diagnosis of pleurisy can be made on the basis of symptoms, listening to the lungs, X-ray and ultrasound examinations, and blood tests for inflammatory parameters. There are two forms of pleurisy: dry pleurisy and wet pleurisy.

Symptoms of dry pleurisy

Dry pleurisy is characterized by symptoms such as severe chest pain when breathing and a dry cough. Breath-related rattling, creaking sounds can be heard on listening. They occur because the pleura and the pleura of the lungs rub against each other. In the case of dry pleurisy, the patient adopts a protective posture, which can serve as a first visible sign in the diagnosis. Fever, on the other hand, does not usually occur. This is different in wet pleurisy.

Symptoms of moist pleurisy

Dry pleurisy often progresses to moist and febrile pleurisy. Often, pleural effusion then occurs. This means that increased fluid gets between the ribs and the lungs. Thanks to this fluid, the severe pain disappears. However, depending on how large the pleural effusion is, a feeling of pressure in the chest and shortness of breath may appear. Sometimes sufferers also complain of shoulder pain because the pleural effusion irritates the phrenic nerve.

Complications of pleurisy

If a pleural effusion is present, it is punctured to relieve the pressure and to examine the fluid for any pathogen or tumor cells. This is because germs can migrate into the effusion, soon causing pus to form. As a result of purulent pleurisy, diaphragmatitis may then develop in turn. Because breathing is often shallow in painful pleurisy, inflamed parts of the pleura lie immobile on top of each other for a long time and may fuse together, especially in purulent pleurisy. The pleura and lung pleura then form rinds, which are known as pleural calluses or pleural swellings. The lung attaches tightly to the rib cage and therefore cannot expand freely when breathing.

Treatment of pleurisy: What to do.

The course, duration, and prognosis of pleurisy depend on the nature of the underlying condition. If pleurisy is treated in a timely manner, it usually heals without complications. Treatment focuses on the primary disease that caused the pleurisy. However, if dry pleurisy is present, pain therapy should definitely be given concomitantly. Since affected patients breathe less easily due to pain, accompanying respiratory gymnastics may be useful. Light food and consistent bed rest are also recommended. In the case of larger effusions, a puncture should be performed. If a bacterial infection is present, it is probably necessary to take an antibiotic.

Treatment with homeopathy and home remedies

Homeopathy has two remedies available for supportive treatment of uncomplicated pleurisy: Bryonia and Cantharis in potencies from D6 to D12. Suitable home remedies include warm chest compresses or hay flower therapy. The hay flowers should come from the pharmacy and are applied in the form of a moist-hot hay bag for about 30 to 40 minutes as a compress.

Treatment of advanced pleurisy.

If pus has formed in the pleural space during wet pleurisy, the purulent fluid should be drained using a chest drain. The purulent pleural cavity can also be irrigated via this drainage (drainage). If the disease is already too advanced, complete drainage of the purulent fluid is no longer possible without surgery. Either the keyhole procedure or open surgery can be considered as an operation. In addition, purulent inflammatory coatings of the lung and pleura should also be removed in this case.

Prevent rind formation by surgery

Rinds resulting from the coalescence of the lung and pleura are characteristic of the last stage of pleurisy. It is advisable to prevent any rind formation by early surgery in the first three to four weeks after the onset of disease. If rinds must be subsequently removed by extensive surgery, it is not always possible to fully restore the efficiency of the lungs.