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pleurisy(plo͝or`ĭsē), inflammation of the pleura (the membrane that covers the lungs and lines the chest cavity). It is sometimes accompanied by pain and coughing. The inflammation may be dry or it may be accompanied by an effusion, or fluid, that fills the chest cavity; when the effusion is infected, the condition is known as empyema. The dry type of pleurisy usually occurs in association with bacterial infections such as pneumonia. Pleurisy with effusion is often associated with such chronic lung conditions as tuberculosis or tumors. Immune disorders such as lupus and rheumatic fever tend to have recurrent pleurisy, with or without effusion. Epidemic pleurodynia, a pleurisy attributed to a virus, is a mild disease of short duration. Treatment of pleurisy is directed at the underlying condition as well as the symptoms.
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.
REFERENCESAbrikosov, A. I. Chastnaiapatologicheskaia anatomiia, fasc. 3. Moscow, 1947.
Rabukhin, A. E. Tuberkuleznye plevrity. Moscow, 1948.
Bolezni sistemy dykhaniia. Edited by T. Garbin’skii. Warsaw, 1967.
A. Z. CHERNOV