Pleurisy as a secondary disease

Pleurisy can occur as a result of various diseases and is not contagious. A distinction is made between dry and wet pleurisy, characterized by different symptoms. If such an inflammation is not treated in time, pus can form, and an operation may be necessary. You can read everything about the signs, course and therapy of pleurisy here.

What is pleurisy?

The pleura is a delicate skin that surrounds the lungs (pleura) and lines the thorax (pleura). In between is a small gap filled with little liquid (pleural gap). The liquid ensures that the lungs and pleura can easily slide past each other when inhaling and exhaling.

In the case of pleurisy (pleuritis), which can occur regardless of age, these two protective membranes are inflamed.

 

Possible causes of pleurisy

Pleurisy is not contagious and usually occurs as a secondary disease.

The following diseases  are possible as underlying diseases:

• pneumonia with the transfer of pathogens to the pleura
• an acute bronchitis
• lung cancer
• a pulmonary embolism
• Tuberculosis
• Diseases of neighbouring organs in the abdomen and pelvis (e.g. inflammation of the renal pelvis)

Pathogens – often bacteria and rarely viruses – that come from distant sources of inflammation can also cause pleurisy.

Pleurisy: Symptoms

The diagnosis of pleurisy can be made based on the symptoms, listening to the lungs, X-ray and ultrasound examinations and blood tests for inflammatory parameters.

There are two forms of pleurisy: dry and wet pleurisy.

 

Symptoms of dry pleurisy

Dry pleurisy is characterized by severe chest pain when breathing and a dry cough. When listening, breathing-dependent rattling and creaking noises can be heard. They arise because the pleura and the lung membrane rub against each other.

In the case of dry pleurisy, the sufferer takes a protective position, which can serve as the first visible sign in the diagnosis. Fever, on the other hand, usually does not occur. It’s different with wet pleurisy.

Symptoms of wet pleurisy

Dry pleurisy often turns into wet and feverish pleurisy. A pleural effusion often occurs. This means that more fluid gets between the ribs and the lungs.

Thanks to this liquid, the severe pain disappears. However, depending on the size of the pleural effusion, a feeling of pressure in the chest and  shortness of breath may appear . Those affected sometimes also complain of  shoulder pain because the pleural effusion irritates the phrenic nerve.

Complications of pleurisy

If there is a pleural effusion, it is punctured to relieve the pressure and examine the fluid for any pathogens or tumor cells. Germs can migrate into the effusion, which soon causes pus to form. As a result of  purulent pleurisy, diaphragm inflammation   can then  develop.

Since breathing is often shallow during painful pleurisy, inflamed parts of the pleura lie immobile on top of each other for a long time and can grow together, especially in purulent pleurisy. The pleura and lungs then form  rinds,  which are known as pleural calluses or pleural rinds. The lungs are firmly connected to the chest and can therefore no longer develop freely when breathing.

 

Treating pleurisy: what to do?

The course, duration and prognosis of pleurisy depend on the nature of the underlying disease. If pleurisy is treated in a timely manner, it usually heals  without complications  . The focus of treatment is the primary disease that triggered the pleurisy.

However, if there is dry pleurisy,  pain therapy  should definitely be given at the same time. Since those affected only breathe in a reduced manner due to pain, accompanying  breathing exercises can be useful. Light food and consistent bed rest are still recommended. 

For larger effusions, a puncture should be performed. If there is a bacterial infection, you will probably need to take an antibiotic.

Treatment with homeopathy and home remedies

Homeopathy   offers two remedies for the supportive treatment of uncomplicated pleurisy: Bryonia and Cantharis in potencies from D6 to D12 .

Suitable home remedies include warm chest wraps or hay flower therapy. The hay flowers should come from the pharmacy and are placed in the form of a moist, hot hay bag as a compress for around 30 to 40 minutes.

Treatment of advanced pleurisy

If pus has formed in the pleural space due to wet pleurisy, the purulent fluid should be drained using a chest tube. The purulent pleural cavity can also be flushed via this  drainage  .

If the disease has already progressed too far, it is no longer possible to completely drain the purulent fluid without surgery. The keyhole procedure or an open operation can be considered an operation. In addition, purulent inflammatory deposits from the lungs and pleura should also be removed.

 

Prevent rind formation through surgery.

Rinds resulting from the fusion of the lung and pleura are characteristic of the final stage of pleurisy. It is advisable to prevent any rind formation through early surgery in the first three to four weeks after the onset of the disease.

If rinds have to be surgically removed afterwards, it is not always possible to completely restore the performance of the lungs.