inflammation of the pleura.
Pleurisy may be infectious or noninfectious. The causative agents in man and animals include the Mycobacterium tuberculosis, cocci, and viruses. In man the most common types are tubercular pleurisy, with primary localization of the infection in the lung or in the lymph nodes, and pleurisy as a complication of inflammation of the lungs. Forms of noninfectious pleurisy are toxic pleurisy, which arises when the pleura is irritated by toxic metabolic products, such as the nitrogenous residues that occur with uremia; traumatic pleurisy; and pleurisy occurring with tumors of the lungs or of the pleura itself. Another form of the disease is primary, or idiopathic, pleurisy, whose etiology has not been established.
Fibrinous pleurisy, with deposit of a dry exudate, fibrin, on the pleurae, occurs with tuberculosis and pneumonia. Exudative pleurisy, in which the fissure between the pleurae is filled with an exudate, may be serous or serofibrinous (tubercular, idiopathic, or rheumatic), hemorrhagic (tubercular or with tumors), or purulent and putrefactive (as with lung abscesses). Pleurisy may be acute or chronic and localized or diffuse.
The symptoms of pleurisy are malaise, fever, chills, perspiration, cough, dyspnea, and changes in the blood’s composition. With dry pleurisy there is pain in the thorax and the sound of pleural friction with auscultation. With exudative pleurisy, a dulling of pulmonary sound is revealed by percussion; diverticulum of the thorax in the region of the exudate may occur, and respiration is severely attenuated. The data of X-ray diagnosis are important. Adhesions may remain after pleurisy. The disease is treated by antibiotics and by antiallergic, anti-inflammatory, and symptomatic agents. The exudate is removed by means of pleurocentesis.
A. Z. CHERNOV