Best Medical Coding Course in Trivandrum
R09.1 Pleurisy
The pleura is the thin membrane that lines the outside of the lungs and the inside of the chest cavity. Pleurisy is an inflammation (swelling or irritation) of these two layers of tissue.The pleural space is a thin area between the chest lining and the membrane that lines the lungs. Fluid lubricates the layers of the pleura so they slide smoothly alongside each other when you breathe. When the membranes become inflamed, they rub painfully against each other instead.
Pleurisy can cause sharp or stabbing chest pain and shortness of breath. It is also called pleuritis.Pleurisy (PLOOR-ih-see) is a condition in which the pleura — two large, thin layers of tissue that separate your lungs from your chest wall — becomes inflamed. Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing.
One pleural layer of tissue wraps around the outside of the lungs. The other pleural layer lines the inner chest wall. Between these two layers is a small space (pleural space) that's usually filled with a very small amount of liquid. Normally, these layers act like two pieces of smooth satin gliding past each other, allowing your lungs to expand and contract when you breathe.
If you have pleurisy, these tissues swell and become inflamed. As a result, the two layers of the pleural membrane rub against each other like two pieces of sandpaper, producing pain when you inhale and exhale. The pleuritic pain lessens or stops when you hold your breath
Symptoms
Signs and symptoms of pleurisy might include:
- Chest pain that worsens when you breathe, cough or sneeze
- Shortness of breath — because you are trying to minimize breathing in and out
- A cough — only in some cases
- A fever — only in some cases
Pain caused by pleurisy might worsen with movement of your upper body and can radiate to your shoulders or back.
Pleurisy can be accompanied by pleural effusion, atelectasis or empyema:
- Pleural effusion. In some cases of pleurisy, fluid builds up in the small space between the two layers of tissue. This is called pleural effusion. When there is a fair amount of fluid, pleuritic pain lessens or disappears because the two layers of pleura are no longer in contact and don't rub together.
- Atelectasis. A large amount of fluid in the pleural space can create pressure, compressing your lung to the point that it partially or completely collapses (atelectasis). This makes breathing difficult and might cause coughing.
- Empyema. The extra fluid can also become infected, resulting in an accumulation of pus. This is called an empyema. An empyema is often accompanied by fever.
When to see a doctor
Call your doctor right away if you experience unexplained, intense chest pain during breathing. You might have a problem with your lungs, heart or pleura or an underlying illness for which you need prompt medical care.
Causes
A variety of underlying conditions can cause pleurisy. Causes include:
- Viral infection, such as the flu (influenza)
- Bacterial infection, such as pneumonia
- Fungal infection
- Autoimmune disorder, such as rheumatoid arthritis or lupus
- Lung cancer near the pleural surface
- Pulmonary embolism
- Tuberculosis (TB)
- Rib fracture or trauma
- Certain inherited diseases, such as sickle cell disease
- Certain medications
Pleurisy diagnosed
Doctors use a medical history and several tests to evaluate for pleurisy. These tests include:
- Biopsy: In some cases, a doctor will take a small sample of lung tissue to determine whether cancer or tuberculosis is present.
- Blood test: Doctors use blood tests to look for signs of infection or autoimmune disorders such as lupus or rheumatoid arthritis.
- Electrocardiogram (EKG or ECG): This test uses small electrodes placed on the chest to measure the heart’s electrical activity. It helps doctors rule out problems or defects of the heart.
- Imaging tests: Imaging tests such as X-rays, CT scans and ultrasounds allow your doctor to see abnormalities in the pleural space, including air, gas or a blood clot.
- Physical exam: Listening to your lungs with a stethoscope allows your doctor to hear a rubbing sound in your lungs that may be a sign of pleurisy.
- Fluid extraction (thoracentesis): A doctor inserts a small needle into the pleural space and removes fluid to look for signs of infection or other causes of pleurisy
Pleurisy treatment depends on the underlying condition causing it. In some cases, pleurisy goes away on its own without treatment.
Your treatment options might include:
- Draining the pleural space: Doctors remove air, blood, or fluid from the pleural space. Depending on how much of the substance needs to be drained, doctors use a needle and syringe (thoracentesis) or a chest tube to suction fluid out of the area.
- Medication: Your doctor might prescribe an antibiotic, an antifungal or an antiparasitic to treat an infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can relieve the pain associated with pleurisy. Corticosteroids can reduce inflammation, but they can produce many side effects. Your doctor may prescribe bronchodilators to make it easier for you to breathe.
- Radiation treatment or chemotherapy: In some cases, doctors use cancer treatments to shrink tumors that cause pleurisy.
The complications associated with pleurisy
Some people with pleurisy experience complications. They include:
- Hemothorax: Blood builds up in the pleural space.
- Pleural effusion: Too much fluid collects in the pleural space. Pleural effusion can cause difficulty in breathing.
- Severe illness from not treating the infection or condition that caused pleurisy in the first place.
You can’t prevent pleurisy, but you can reduce your risk by promptly treating conditions that may cause it. You should also quit smoking tobacco, using electronic cigarettes, and smoking marijuana. If you don’t smoke, don’t start.
Risk of developing pleurisy
People of Mediterranean descent have a higher risk for pleurisy due to a hereditary condition called familial Mediterranean fever. People with other underlying conditions that can lead to pleurisy are also at higher risk for the disorder. These conditions include:
- Asbestosis (lung disease caused by inhaling asbestos).
- Autoimmune disorders such as lupus and rheumatoid arthritis.
- Cancers of the respiratory system such as lung cancer, asthma, and COPD.
- Chest surgery or trauma.
- Inflammatory bowel disease.
- Taking certain medications, including hydralazine, isoniazid, and procainamide.
Comments
Post a Comment