Tuberculous pleurisy

Tuberculous pleurisy by Mycobacterium tuberculosis infection and disease caused by pleurisy. Clinical usually divided into dry pleurisy, pleurisy, tuberculosis empyema (rare) types. Onset may be anxious relief, more than sharp. Systemic poisoning symptoms : a high degree of fever, night sweating, weakness, general discomfort. Local symptoms can be chest pain, dry cough and large pleural effusion may be short breath and chest tightness, and center breathing and cyanosis. Stem pleurisy ipsilateral respiratory movement is restricted, local tenderness, touching pleural friction flu, auscultation pleural friction sound. Exudative pleural effusion more pleurisy, the ipsilateral thorax satiated and intercostal space widened, respiratory movement, weakened language chatter, trachea and heart to the contralateral displacement, liquid level is attending voiced deduction, breath sounds weakened or disappeared, on the plane before it bronchoalveolar lavage breath sounds, the occasional sound of small blisters. Right pleural effusion liver voiced sector disappeared. For pleurodesis hypertrophy local thoracic subsidence, the respiratory movement restricted deduction attendance voiced, breath sounds weakened. Examination : (1) Conventional check : blood, erythrocyte sedimentation rate, liver function, blood sugar, hepatitis B 5 TB-AB. (2) bacteriology : sputum smear, bacteria set pleural effusion, pleural effusion or training tuberculosis mycobacterium tuberculosis investigation. (3) hydrothorax : conventional, chemical, biological, pleural fluid and blood and protein ratio of LDH, ADA. (4) X-ray, chest roentgenogram is necessary when making high-KV, CT or CT scan. (5) Ultrasonic Inspection : A chest - or B-scan can detect the liquid levels and positioning. (6) tuberculin test. (7) pulmonary function tests. (8) pleural biopsy, bacteriological examination negative. (9) Thoracoscopy : for the above checks were not confirmed. Diagnosis : (1) the above symptoms, signs, Chest showed that the images of pleural effusion (2) pleural effusion conventional and biochemical tests with effusion (3) found tuberculosis pleural effusion, pleural or thoracoscopic biopsy revealed tuberculosis. (4) pleural effusion ADA>50u/L, ELISA resistance rate is high and rising LDH help diagnosis. (5) Guitar-test : strong positive. Negative tuberculosis can not be ruled out. (6) A - or B - ultrasound examination showed fluid. (7) immunoassay : TB-AB, SCIC, soluble interleukin-2 receptor. (8) should exclude other causes of pleural effusion, pleural available when necessary biopsy. The disease that medical treatment, including attention to the rest, symptomatic treatment, anti-tuberculosis treatment, pleural puncture fluid; If necessary, use of adrenocorticotropic hormone (severe toxicity symptoms, pleural effusion more). In combination with the clinical manifestations of the disease is generally a Chinese "hanging drink," "cough" and "chest pain" and so on. Pathogenesis frequently evils violations of the lungs, causing pulmonary Sluggishness the drop. Atelectasis fall, pulmonary hit, it was manifested as coughing, chest pain; Pulmonary missing links stressed that drinking water stagnation pleural effusion were seen waiting. Treatment focuses on xiefei in water, pesticide antidote.