Definition of Pleurisy
It is inflammation of the pleura ( the membrane that surrounds the lung ) as a result of irritation .Causes
1- Primary : viral, TB., malignancy.
2- Secondary : to systemic disease as S.L.E., FMF, Rheumatoid disease
3- Extension from near by structures
Clinical Picture
(Pleurisy is not a diagnosis but simply the term used to describe an underlying disease)1- Chest pain : • stitching • localized • increase with cough & inspiration .
2- False dyspnea due to pleuritic pain
3- Diminished chest expansion in the affected side, palpable pleural rub may be present (pleural fremitus).
3- Pleural rub or pleuropericardial rub by auscultation.
Defferential diagnosis of Acute dry Pleurisy
• Other causes of acute chest pain • Differentiation between causes of pleurisyInvestigations : Directed to the cause e.g.:
• Plain X ray for pneumonia • Lung scan for pulmonary infarction
• Markers for SLE, rheumatoid disease.
Treatment
- NSAID for pain.
- Specific treatment for the cause.