Tuberculosis Pleurisy

Tuberculosis is a major cause of young people epanşmanının pleura. The period of primary tuberculous pleurisy is more, a few weeks or a few months after having a positive tuberculin reaction is husule. Pleural lymphatic drainage of a caseous granuloma Subplöral direct effect or the disease causes progressive visceral pleura infiltration pleurisy. Pulmonary lesions of tuberculous pleurisy than once a clinical or radiological evidence of specific observed.

Pörezisi acute or subacute hematogenous tuberculosis can also occur as a result of deployments. Hematogenous release of bilateral pleural effusion is seen quite often. Ribs, vertebrae and mediastinal lymph nodes tuberculosis pleural effusion and empyema are known to spread. These are similar to primary tuberculous pleurisy-tion. Kavernli adult tuberculosis may occur in the pleurisy

Clinical symptoms

The main clinical symptoms of tuberculosis pleurisy fever, chest pain and dyspnea (Triple symptom). Not be important, and dry cough, sputum production, not landing. Usually an acute onset of the disease a few days or few weeks, completed all three symptoms. As the liquid becomes more severe fever, and dyspnea. The pain usually niteliğindedir pleural pain. Furthermore, weakness, fatigue, weight loss and there are systemic symptoms such as sweating. The patient's general appearance is pretty good, not bad as well as acute and serious infection. Patient hemitorax movement is limited, there is dullness and decreased breath sounds. Frotman audible at startup. But the leaves thoroughly, then left pleural fluid has improved for two frotman inaudible. Rai is rare. Ögofoni and breath sounds can be heard just above the liquid increases. Very fluid together at the opposite side mediastinum, the diaphragm is pushed down, and the other party bombeleşir paravertebral intercostal spaces are taken in the dullness. Increased sedimentation. Other laboratory findings often are normal. Tuberculin test is positive. In rare cases were negative, but positive in the weeks after the recovery would be balance in the immune-sensitivity.

Radiological findings

Both tuberculosis, chest radiography and pleural effusions due to other reasons, the most useful diagnostic method. A moderate who occupied the lower part of a hemithorax pleurisy, heart and diaphragm, covering the homogeneous limit is a concentration. Upper limit of the full non-specific medial border of the concentration above the limit of late Rai, concavity upward and inward-looking view of the border vardır.Üst Damoiseau this shape is called a line. Side radiograph better determine the localization of the liquid.

Laboratory

Clear yellow fluid and pleural exudate niteliğindedir taken. 500-2000 / mm3, WBC has. Lenfosittir majority of leukocytes (60-90%). If the suspicion of tuberculous pleural puncture should be repeated after a period of time. Koch bacillus culture positive in 40% of cases. Other bacteria in the liquid culture-negative bacillus Koch made ​​tir.Fazla liquid culture increases the chances of reproduction. 70-parietal pleural biopsy in 80% of cases were granulomatous or granuloma was not seen. If necessary, a few are made ​​from the biopsy, diagnosis increases the chance. Pleuroscopy yardımıyle pleural biopsy is performed flexible fiberoptic visualization is a more positive result. Histopathologic examination and culture is made. Antituberculosis drugs evaluated in the study of culture sensitivity.

Treatment

Rest and thoracentesis with pleural tuberculosis was resolved a few weeks may be lost. Cases of tuberculosis a few years later without specific treatment required the activation of re-infection is a common development.
Clinical and radiological examination of pleural fluid should be aspirated edilince plönezi diagnosis. However, liquid should not be more than one thoracentesis 1000. Usually 2-3 times intraplöral aspirations fully drained of fluid. The disease is diagnosed in the place of three or four antituberculosis drugs and corticosteroids. Streptomycin (S), isoniazid (H), rifampin (R), Ethambutol (E) and pyrazinamide (Z) to begin treatment with antituberculosis drugs, four of them (Shrek). S + H + R is used many times at the beginning. Streptomycin 1 gm IM daily in adults, 300-400 mg per day of oral isoniazid, ethambutol 1000-1500 mg orally per day, rifampin 600 mg per day given orally. Streptomycin 1 gm daily dose is given IM at a time. Oral drugs are given meal a day at a time or two.

Corticosteroids prevent adhesions and facilitate absorption of liquid. 30-40 mg prednisone or equivalent per day of oral steroids are given for 2-3 weeks. After that 2-5 mg per day reduced the last few weeks of treatment with oral doses of verilir.Günlük meal is 2-3. Steroid dose and duration of treatment and the result set according to the seriousness of the disease. Antituberculosis drug and steroid therapy, fever, pain, fatigue, cough, anorexia symptoms such as feeling unwell a few days and the patient recovers. Pleural Effusion in the first period (acute phase), the hospital should be treated. Many times this time 3-6 weeks. After this treatment, the triple (H + R + M) or dual drug (H + R) 12 months continue to be ambulatory drug sensitivity of bacteria examined edilir.Tüberküloz should change the result, according to the treatment protocol. This is very important. Or incomplete treatment of tuberculosis patients in Turkey are not treated because of increasing drug resistance in tuberculosis bacteria.

Tuberculosis pleurisy geçirenlerin regular and healthy life is required. And often done in clinical and radiological controls. Koch's bacilli of tuberculosis pleurisy is treated effectively with drugs for 12 months. H and R and longer in treatment-resistant cases. Untreated patients with tuberculous pleurisy treated with or missing in the future may be the activation of pulmonary tuberculosis or extrapulmonary tuberculosis.

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