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Pulmonary fibrosis causes, types, diagnosis and treatment

This article is to discuss lung fibrosis regarding its known types , aetiology, clinical picture (manifestations), investigations and management .

Types of pulmonary fibrosis

Types-pulmonary-fibrosis1• Interstitial pulmonary fibrosis .
2• Parenchymatous pulmonary fibrosis .

Etiology ( Causes of  pulmonary fibrosis ):

 TB - lung abscess - Bronchiectasis - Empyema

Clinical picture 
Pulmonary fibrosis (parenchymatous)
1- Manifestations of the cause or past history of TB - lung abscess - Bronchiectasis - Empyema
2- Dyspnea, chronic dry cough .
3- Cyanosis (In advanced stage)

Local examination

(The affected side showing multiple negative signs):
Inspection :  Diminished movement, retraction.

Palpation   : TVF  Low, diminished chest expansion, trachea deviated to the same side of the lesion.

TVF is High with Marked tracheal shift to the same side

Percussion :  Dullness, if the fibrosis is left sided it does not affect the traube's area (resonant traube's area), to be differentiated
from left sided pleural effusion.

Auscultation : Diminished Air entery - or diminished intensity of breath sounds, coarse non consonating crepitations .

Investigations
* X-ray shows :
Crowded ribs, trachea shifted to the same side , Heterogenous opacity, Tenting of diaphragm
* Pulmonary function tests showing restrictive hypoventilation.

Treatment of  pulmonary fibrosis

• Treatment of the cause if possible.
• Symptomatic treatment e.g. antitussive for cough
• Treatment of complications e.g cor pulmonale and respiratory failure.
• Lung transplantation in advanced cases.
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Tamer Mobarak

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