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Pleurisy (PLUR-ih-se) is a condition in which the pleura is inflamed. The pleura is a membrane that consists of two large, thin layers of tissue. One layer wraps around the outside of your lungs. The other layer lines the inside of your chest cavity.

Between the layers of tissue is a very thin space called the pleural space. Normally this space is filled with a small amount of fluid—about 4 teaspoons full. The fluid helps the two layers of the pleura glide smoothly past each other as you breathe in and out.

Pleurisy occurs if the two layers of the pleura become irritated and inflamed. Instead of gliding smoothly past each other, they rub together every time you breathe in. The rubbing can cause sharp pain.

Many conditions can cause pleurisy, including viral infections.

Other Pleural Disorders

Pneumothorax

Air or gas can build up in the pleural space. When this happens, it's called a pneumothorax (noo-mo-THOR-aks). A lung disease or acute lung injury can cause a pneumothorax. 

Some lung procedures also can cause a pneumothorax. Examples include lung surgery, drainage of fluid with a needle, bronchoscopy (bron-KOS-ko-pee), and mechanical ventilation.

Sometimes the cause of a pneumothorax isn't known.

The most common symptoms of a pneumothorax are sudden pain in one side of the lung and shortness of breath. The air or gas in the pleural space also can put pressure on the lung and cause it to collapse.

Pleurisy and Pneumothorax

 

A small pneumothorax may go away without treatment. A large pneumothorax may require a procedure to remove air or gas from the pleural space.

A very large pneumothorax can interfere with blood flow through your chest and cause your blood pressure to drop. This is called a tension pneumothorax.

Pleural Effusion

In some cases of pleurisy, excess fluid builds up in the pleural space. This is called a pleural effusion. A lot of extra fluid can push the pleura against your lung until the lung, or part of it, collapses. This can make it hard for you to breathe.

Sometimes the extra fluid gets infected and turns into an abscess. When this happens, it's called an empyema (em-pi-E-ma).

You can develop a pleural effusion even if you don't have pleurisy. For example, pneumonia, (nu-MO-ne-ah), heart failure, cancer, or pulmonary embolism (PULL-mun-ary EM-bo-lizm) can lead to a pleural effusion.

Hemothorax

Blood also can build up in the pleural space. This condition is called a hemothorax (he-mo-THOR-aks). An injury to your chest, chest or heart surgery, or lung or pleural cancer can cause a hemothorax.

A hemothorax can put pressure on the lung and cause it to collapse. A hemothorax also can cause shock. In shock, not enough blood and oxygen reach your body's vital organs.

Outlook

Pleurisy and other pleural disorders can be serious, depending on their causes. If the condition that caused the pleurisy or other pleural disorder isn't too serious and is diagnosed and treated early, you usually can expect a full recovery.

 

Other Names for Pleurisy and Other Pleural Disorders

  • Pleurisy also is called pleuritis and pleuritic chest pain.
  • Pleural effusion also is called fluid in the chest and pleural fluid.
  • Pneumothorax also is called air around the lung and air outside the lung

 

What Causes Pleurisy and Other Pleural Disorders?

Pleurisy

Many conditions can cause pleurisy. Viral infections are likely the most common cause. Other causes of pleurisy include:

  • Bacterial infections, such as pneumonia (nu-MO-ne-ah) and tuberculosis, and infections from fungi or parasites
  • Pulmonary embolism, a blood clot that travels through the blood vessels to the lungs
  • Autoimmune disorders, such as lupus and rheumatoid arthritis
  • Cancer, such as lung cancer, lymphoma, and mesothelioma (MEZ-o-thee-lee-O-ma)
  • Chest and heart surgery, especially coronary artery bypass grafting
  • Lung diseases, such as LAM (lymphangioleiomyomatosis) or asbestosis (as-bes-TO-sis)
  • Inflammatory bowel disease
  • Familial Mediterranean fever, an inherited condition that often causes fever and swelling in the abdomen or lungs

Other causes of pleurisy include chest injuries, pancreatitis (an inflamed pancreas), and reactions to certain medicines. Reactions to certain medicines can cause a condition similar to lupus. These medicines include procainamide, hydralazine, and isoniazid.

Sometimes doctors can't find the cause of pleurisy.

Pneumothorax

Lung diseases or acute lung injury can make it more likely that you will develop a pneumothorax (a buildup of air or gas in the pleural space). Such lung diseases may includeCOPD (chronic obstructive pulmonary disease), tuberculosis, and LAM.

Surgery or a chest injury also may cause a pneumothorax.

You can develop a pneumothorax without having a recognized lung disease or chest injury. This is called a spontaneous pneumothorax. Smoking increases your risk of spontaneous pneumothorax. Having a family history of the condition also increases your risk.

Pleural Effusion

The most common cause of a pleural effusion (a buildup of fluid in the pleural space) is heart failure. Lung cancer, LAM, pneumonia, tuberculosis, and other lung infections also can lead to a pleural effusion.

Sometimes kidney or liver disease can cause fluid to build up in the pleural space. Asbestosis, sarcoidosis (sar-koy-DO-sis), and reactions to some medicines also can lead to a pleural effusion.

Hemothorax

An injury to the chest, chest or heart surgery, or lung or pleural cancer can cause a hemothorax (buildup of blood in the pleural space).

A hemothorax also can be a complication of an infection (for example, pneumonia), tuberculosis, or a spontaneous pneumothorax.

 

What Are the Signs and Symptoms of Pleurisy and Other Pleural Disorders

Pleurisy

The main symptom of pleurisy is a sharp or stabbing pain in your chest that gets worse when you breathe in deeply or cough or sneeze.

The pain may stay in one place or it may spread to your shoulders or back. Sometimes the pain becomes a fairly constant dull ache.

Depending on what's causing the pleurisy, you may have other symptoms, such as:

  • Shortness of breath or rapid, shallow breathing
  • Coughing
  • Fever and chills
  • Unexplained weight loss

Pneumothorax

The symptoms of pneumothorax include:

  • Sudden, sharp chest pain that gets worse when you breathe in deeply or cough
  • Shortness of breath
  • Chest tightness
  • Easy fatigue (tiredness)
  • A rapid heart rate
  • A bluish tint to the skin caused by lack of oxygen

Other symptoms of pneumothorax include flaring of the nostrils; anxiety, stress, and tension; and hypotension (low blood pressure).

Pleural Effusion

Pleural effusion often has no symptoms.

Hemothorax

The symptoms of hemothorax often are similar to those of pneumothorax. They include:

 

How Are Pleurisy and Other Pleural Disorders Diagnosed?

Your doctor will diagnose pleurisy or another pleural disorder based on your medical history, a physical exam, and test results.

Your doctor will want to rule out other causes of your symptoms. He or she also will want to find the underlying cause of the pleurisy or other pleural disorder so it can be treated.

Medical History

Your doctor may ask detailed questions about your medical history. He or she likely will ask you to describe any pain, especially:

  • What it feels like
  • Where it's located and whether you can feel it in your arms, jaw, or shoulders
  • When it started and whether it goes away and then comes back
  • What makes it better or worse

Your doctor also may ask whether you have other symptoms, such as shortness of breath,coughing, or palpitations. Palpitations are feelings that your heart is skipping a beat, fluttering, or beating too hard or fast.

Your doctor also may ask whether you've ever:

  • Had heart disease.
  • Smoked.
  • Traveled to places where you may have been exposed to tuberculosis.
  • Had a job that exposed you to asbestos. Asbestos is a mineral that, at one time, was widely used in many industries.

Your doctor also may ask about medicines you take or have taken. Reactions to some medicines can cause pleurisy or other pleural disorders.  

Physical Exam

Your doctor will listen to your breathing with a stethoscope to find out whether your lungs are making any abnormal sounds.

If you have pleurisy, the inflamed layers of the pleura make a rough, scratchy sound as they rub against each other when you breathe. Doctors call this a pleural friction rub. If your doctor hears the friction rub, he or she will know that you have pleurisy.

If you have a pleural effusion, fluid buildup in the pleural space will prevent a friction rub. But if you have a lot of fluid, your doctor may hear a dull sound when he or she taps on your chest. Or, he or she may have trouble hearing any breathing sounds.

Muffled or dull breathing sounds also can be a sign of a pneumothorax (a buildup of air or gas in the pleural space).

Diagnostic Tests

Depending on the results of your physical exam, your doctor may recommend tests.

Chest X Ray

chest x ray is a painless test that creates a picture of the structures in your chest, such as your heart, lungs, and blood vessels. This test may show air or fluid in the pleural space.

A chest x ray also may show what's causing a pleural disorder—for example, pneumonia, a fractured rib, or a lung tumor.

Sometimes a chest x ray is taken while you lie on your side. This position can show fluid that didn't appear on an x ray taken while you were standing.

Chest CT Scan

A chest computed tomography (to-MOG-rah-fee) scan, or chest CT scan, is a painless test that creates precise pictures of the structures in your chest.

This test provides a computer-generated picture of your lungs that can show pockets of fluid. A chest CT scan also may show signs of pneumonia, a lung abscess, a tumor, or other possible causes of pleural disorders.

Ultrasound

This test uses sound waves to create pictures of your lungs. An ultrasound may show where fluid is located in your chest. The test also can show some tumors.

Chest MRI

A chest magnetic resonance imaging scan, or chest MRI, uses radio waves, magnets, and a computer to created detailed pictures of the structures in your chest. This test can show pleural effusions and tumors.

This test also is called a magnetic resonance (MR) scan or a nuclear magnetic resonance (NMR) scan.

Blood Tests

Blood tests can show whether you have an illness that increases your risk of pleurisy or another pleural disorder. Such illnesses include bacterial or viral infections, pneumonia, pancreatitis (an inflamed pancreas), kidney disease, or lupus.

Arterial Blood Gas Test

For this test, a blood sample is taken from an artery, usually in your wrist. The blood's oxygen and carbon dioxide levels are checked. This test shows how well your lungs are taking in oxygen.

Thoracentesis

Once your doctor knows whether fluid has built up in the pleural space and where it is, he or she can remove a sample for testing. This is done using a procedure called thoracentesis (THOR-ah-sen-TE-sis).

During the procedure, your doctor inserts a thin needle or plastic tube into the pleural space and draws out the excess fluid. After the fluid is removed from your chest, it's sent for testing.

The risks of thoracentesis—such as pain, bleeding, and infection—usually are minor. They get better on their own, or they're easily treated. Your doctor may do a chest x ray after the procedure to check for complications.

Fluid Analysis

The fluid removed during thoracentesis is examined under a microscope. It's checked for signs of infection, cancer, or other conditions that can cause fluid or blood to build up in the pleural space.

Biopsy

Your doctor may suspect that tuberculosis or cancer has caused fluid to build up in your pleural space. If so, he or she may want to look at a small piece of the pleura under a microscope.

To take a tissue sample, your doctor may do one of the following procedures:

  • Insert a needle into your chest to remove a small sample of the pleura's outer layer.
  • Insert a tube with a light on the end (endoscope) into tiny cuts in your chest wall so that he or she can see the pleura. Your doctor can then snip out small pieces of tissue. This procedure must be done in a hospital. You'll be given medicine to make you sleep during the procedure.
  • Snip out a sample of the pleura through a small cut in your chest wall. This is called an open pleural biopsy. It's usually done if the sample from the needle biopsy is too small for an accurate diagnosis. This procedure must be done in a hospital. You'll be given medicine to make you sleep during the procedure.

How Are Pleurisy and Other Pleural Disorders Treated?

Pleurisy and other pleural disorders are treated with procedures, medicines, and other methods. The goals of treatment include:

  • Relieving symptoms
  • Removing the fluid, air, or blood from the pleural space (if a large amount is present)
  • Treating the underlying condition

Relieving Symptoms

To relieve pleurisy symptoms, your doctor may recommend:

  • Acetaminophen or anti-inflammatory medicines (such as ibuprofen) to control pain.
  • Codeine-based cough syrups to control coughing.
  • Lying on your painful side. This might make you more comfortable.
  • Breathing deeply and coughing to clear mucus as the pain eases. Otherwise, you may develop pneumonia.
  • Getting plenty of rest.

Removing Fluid, Air, or Blood From the Pleural Space

Your doctor may recommend removing fluid, air, or blood from your pleural space to prevent a lung collapse.

The procedures used to drain fluid, air, or blood from the pleural space are similar.

  • During thoracentesis, your doctor will insert a thin needle or plastic tube into the pleural space. An attached syringe will draw fluid out of your chest. This procedure can remove more than 6 cups of fluid at a time.
  • If your doctor needs to remove a lot of fluid, he or she may use a chest tube. Your doctor will inject a painkiller into the area of your chest wall where the fluid is. He or she will then insert a plastic tube into your chest between two ribs. The tube will be connected to a box that suctions out the fluid. Your doctor will use a chest x ray to check the tube's position.
  • Your doctor also can use a chest tube to drain blood and air from the pleural space. This process can take several days. The tube will be left in place, and you'll likely stay in the hospital during this time.

Sometimes the fluid in the pleural space contains thick pus or blood clots. It may form a hard skin or peel, which makes the fluid harder to drain. To help break up the pus or blood clots, your doctor may use a chest tube to deliver medicines called fibrinolytics to the pleural space. If the fluid still won't drain, you may need surgery.

If you have a small, persistent air leak into the pleural space, your doctor may attach a one-way valve to the chest tube. The valve allows air to exit the pleural space, but not reenter. Using this type of valve may allow you to continue your treatment from home.

Treat the Underlying Condition

The fluid sample that was removed during thoracentesis will be checked under a microscope. This can tell your doctor what's causing the fluid buildup, and he or she can decide the best way to treat it.

If the fluid is infected, treatment will involve antibiotics and drainage. If you have tuberculosis or a fungal infection, treatment will involve long-term use of antibiotics or antifungal medicines.

If tumors in the pleura are causing fluid buildup, the fluid may quickly build up again after it's drained. Sometimes antitumor medicines will prevent further fluid buildup. If they don't, your doctor may seal the pleural space. Sealing the pleural space is called pleurodesis (plur-OD-eh-sis).

For this procedure, your doctor will drain all of the fluid out of your chest through a chest tube. Then he or she will push a substance through the chest tube into the pleural space. The substance will irritate the surface of the pleura. This will cause the two layers of the pleura to stick together, preventing more fluid from building up.

Chemotherapy or radiation treatment also may be used to reduce the size of the tumors.

If heart failure is causing fluid buildup, treatment usually includes diuretics (medicines that help reduce fluid buildup) and other medicines.

 

Source: http://www.nhlbi.nih.gov/health/health-topics/topics/pleurisy/

Contents

Introduction. 

Symptoms of pericarditis

Causes of pericarditis

Diagnosing pericarditis

Treating pericarditis

Complications of pericarditis

 

Introduction 

Pericarditis is swelling of the pericardium, which is the fluid-filled sac surrounding your heart.

The main symptom of pericarditis is chest pain. This can be a sudden, sharp and stabbing pain behind your breastbone or more of a dull ache. The pain is often worse when lying down or breathing in, and better when sitting up.

Pericarditis is not usually a serious condition and may be treated on an outpatient basis, so you don't have to be admitted to hospital.

Read more about the symptoms of pericarditis.

Types of pericarditis

There are three main types of pericarditis:

  • acute pericarditis – where the symptoms last less than three months (with treatment, symptoms normally resolve within a week) and often appear after flu-like symptoms
  • recurring pericarditis – where someone has repeated episodes of acute pericarditis
  • chronic pericarditis – a complication of pericarditis, where the symptoms last longer than three months

Why does pericarditis happen?

In most cases of pericarditis, no cause is identified. However, an infection is usually thought to be responsible.

Other things that may cause pericarditis include chest injury, some cancers and some treatments, such as radiotherapy or chemotherapy.

Problems with the body's immune system may also play a role in recurring and chronic pericarditis.

Read more about the causes of pericarditis.

How is pericarditis treated?

Acute pericarditis can usually be treated with medication to reduce swelling, such as non-steroidal anti-inflammatory drugs (NSAIDs), although antibiotics may be used if there is a bacterial infection.

A medication called colchicine is often used for recurring pericarditis, as it can prevent symptoms returning.

Treatment for chronic pericarditis will depend on the underlying cause. Some cases respond well to medication, while others may require surgery.

Read more about treating pericarditis.

Cardiac tamponade

In rare cases, pericarditis can trigger a serious complication known as cardiac tamponade. This is an excess build-up of fluid inside the pericardium. The extra fluid places too much pressure on the heart, so it is unable to beat properly.

Cardiac tamponade can cause symptoms such as:

  • light-headedness
  • blurred vision
  • palpitations
  • nausea

Cardiac tamponade also often occurs alongside inflammation of the heart muscle (myocarditis). This causes pain that feels like pressure on the chest, similar to a heart attack.

Cardiac tamponade is life-threatening and requires emergency treatment. If you have a history of pericarditis and develop the symptoms listed above, call 999 and ask for an ambulance.

Read more about the complications of pericarditis.

Who is affected?

Pericarditis is a relatively common heart condition. Around 5% of all admissions to accident and emergency (A&E) departments for severe chest pain are diagnosed as pericarditis.

Pericarditis tends to be more common in men than women. It can affect people of all ages, but mostly occurs in young adults.

Symptoms of pericarditis 

The most common symptom of all types of pericarditis is chest pain.

Most people who have had pericarditis describe experiencing a sudden sharp pain, usually behind their breastbone, on the left side of their body. Some people describe the pain as more like a dull ache or feeling of pressure.

The pain may also radiate up from your chest into your left shoulder and neck.

It's usually worse when breathing in, coughing, eating and lying down. Sitting up or leaning forward will usually help relieve the pain.

When to seek medical advice

Always seek immediate medical advice if you experience sudden chest pain chest pain. While most cases of pericarditis are not serious, it's important that other more serious conditions are ruled out, such as a heart attack or a blood clot.

Visit your local accident and emergency (A&E) department or telephone NHS 111 as soon as possible.

Additional symptoms

Depending on the underlying cause of your pericarditis, you may also experience:

  • a high temperature (fever) 
  • shortness of breath
  • fatigue
  • nausea
  • dry cough
  • swelling of the legs or abdomen

In some cases, pericarditis occurs along with myocarditis, which is inflammation of the heart muscle.

If these symptoms only occur for a short time or a one-off episode, it's called "acute pericarditis". However, if they last three months or more, it's known as "chronic pericarditis".

Read about the complications of pericarditis for more information.

Recurring pericarditis

Recurring pericarditis is when you experience frequent episodes of pericarditis.

There are two main types of recurring pericarditis:

  • Incessant pericarditis – symptoms develop once medications such as non-steroidal anti-inflammatory drugs (NSAIDs) are withdrawn. Symptoms usually begin within six weeks of the treatment being withdrawn.
  • Intermittent pericarditis – there are long periods without any symptoms (often many months or sometimes years) before symptoms return without warning.

It's estimated that one in four people with a history of acute pericarditis will develop recurring pericarditis.

Causes of pericarditis 

It's not always clear what causes pericarditis, although a viral infection is usually suspected.

In around 90% of acute pericarditis cases, no obvious cause can be found to explain why the pericardium has become inflamed. This is known as idiopathic pericarditis. 

Many cases are thought to be the result of viral infections, which can't be detected.

Viral infections

Viral infections associated with acute pericarditis include:

Other causes

Other less common causes of acute pericarditis include:

  • bacterial infection, particularly tuberculosis
  • autoimmune conditions such as rheumatoid arthritis or lupus, where the immune system attacks healthy tissues
  • radiotherapy – the radiation used in radiotherapy can damage the tissue of the pericardium, and breast cancer or lung cancer patients may be at particular risk
  • kidney failure – exactly why kidney failure causes acute pericarditis is unclear
  • underactive thyroid gland (hypothyroidism) – exactly why hypothyroidism causes acute pericarditis is unclear
  • cancer – cancer that spreads from other parts of the body to the pericardium can damage tissue
  • heart attacks – pericarditis can sometimes develop after a heart attack, as damaged heart muscles can irritate the pericardium
  • injury or irritation to the tissue of the pericardium that occurs during heart surgery
  • severe injury to the chest – for example, following a car accident
  • some medications, such as penicillin or some chemotherapy medicines, have been known to trigger acute pericarditis as a side effect in some people

Recurring pericarditis

The cause of recurring pericarditis is still unknown.

One theory suggests that your immune system may be responsible. Your immune system reacts months or even years after the initial infection that caused acute pericarditis and attacks the heart, leading to inflammation of the pericardium.

Another theory suggests that fragments of the virus may lay inactive in the tissue of the pericardium and suddenly reactivate, triggering the process of inflammation.

People treated with steroids during their first episode of acute pericarditis are six times more likely to develop recurring pericarditis than people who don't receive this treatment. Because of this, steroids are used as a last resort, if you fail to respond to other medications.

Diagnosing pericarditis 

Your doctor will ask about your symptoms and recent medical history, such as whether you've recently had a chest infection or been in an accident.

They will listen to your heart with a stethoscope, as pericarditis can change the sound of your heartbeat to a distinctive rasping or grating sound.

You may have blood tests to check for infections and how organs such as your liver and kidneys are functioning.

In some cases, a needle may be used to drain any fluid from around your heart, so it can be tested.

A diagnosis is usually confirmed by electrocardiogram (ECG). During an ECG, electrodes are placed on your skin to measure the electrical activity of your heart.

People with pericarditis usually experience a distinctive change in the electrical activity of the heart, which can be detected with an ECG.

Further testing

Further testing is usually only required if other tests prove negative or you have additional symptoms not normally associated with pericarditis, such as swelling of the arms and legs or extreme tiredness.

These tests may include:

Treating pericarditis 

Pericarditis is usually treated with medication, although surgery is used in rare cases.

You will be assessed to see whether it's safe for you to be treated at home.

You will usually be admitted to hospital if:

  • you have a high temperature (fever) of 38C (100.4F) or above
  • you have a high number of white blood cells – this could be the result of a serious infection
  • your symptoms develop after a sudden injury to your chest
  • you take blood-thinning medication (anticoagulants)
  • blood tests show you have high levels of a type of protein called troponin in your blood (this can be the result of damage to the heart muscle)
  • there is a risk of you developing cardiac tamponade, a serious complication of pericarditis caused by a build-up of fluid around the heart

You may also be admitted to hospital if treatment doesn't work.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Most cases of pericarditis can be successfully treated with non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs work by reducing the inflammation of the pericardium, and also relieve the chest pain.

Ibuprofen is the preferred choice of NSAID. The exception is if you've recently had a heart attack, as ibuprofen can interfere with the healing of your heart. In such circumstances, high-dose aspirin will usually be recommended.

As NSAIDs can occasionally cause stomach ulcers, you will probably be prescribed an additional medication called a proton pump inhibitor that provides protection against stomach ulcers.

Colchicine

Colchicine is a medicine that can be used on its own or in combination with NSAIDs.

It's often used if your symptoms fail to respond to NSAIDs or you are unable to take NSAIDs because of a pre-existing medical condition. 

Colchicine is useful because it can reduce inflammation of the pericardium by killing certain cells.

Side effects of colchicine include:

  • abdominal pain
  • vomiting
  • diarrhoea

These side effects usually improve once your body gets used to the medication.

Colchicine does not currently have a licence to be used to treat pericarditis in the UK. However, studies have shown that colchicine can be effective in treating pericarditis, so you may still be prescribed it if the benefits outweigh any potential risks.

Corticosteroids

Corticosteroids are usually only given when the symptoms of pericarditis fail to respond to NSAIDs and colchicine, or there is a build-up of fluid inside the pericardium, which could put the heart at risk.

Corticosteroids block the effects of the immune system, leading to a reduction in inflammation.

Corticosteroids are powerful medicines and can have a range of side effects, especially if used for a long period of time.

Side effects of corticosteroids include:

  • weight gain
  • mood swings
  • increased sweating

Other treatments

Treatment for pericarditis is different if it's not caused by a viral infection. For example, if your pericarditis is caused by a bacterial infection, such as tuberculosisantibiotics are used.

In some cases, the fluid that builds up around the heart may be drained with a needle during a procedure called pericardiocentesis. However, this is usually only used if you develop complications of pericarditis.

Recurring pericarditis

NSAIDs can be used to relieve symptoms of an episode of pericarditis, while a long-term course of colchicine has proved effective in preventing symptoms returning.

If symptoms persist, then a short-course of steroid medication may be recommended.

If your symptoms are particularly severe and not responding to medication, a type of surgery known as pericardiectomy may be recommended.

This involves the surgeon making a large incision in your chest and removing some or all of your pericardium.

A pericardiectomy is usually regarded as a last resort, as the surgery is relatively risky – there is an estimated 1 in 20 chance of it causing death.

Complications of pericarditis 

In rare cases, pericarditis can develop into further problems, some of which can be life-threatening.

Chronic pericarditis

Chronic pericarditis is defined as pericarditis that persists for more than three months.

There are two main types of chronic pericarditis:

  • chronic effusive pericarditis – when an excess of fluid gathers in the space inside the pericardium
  • chronic constrictive pericarditis – the tissue of the pericardium becomes hardened through scarring

Chronic effusive pericarditis

It's hard to estimate exactly how widespread chronic effusive pericarditis is, as most cases do not cause any noticeable symptoms. One study estimated that 1 in 20 older adults have some degree of fluid build-up inside their pericardium.

It can cause the following symptoms:

  • chest pain
  • light-headedness
  • shortness of breath

Possible causes of chronic effusive pericarditis include:

  • infections – such as hepatitis or tuberculosis
  • cancers that spread from other parts of the body to the pericardium
  • damage or injury that occurs during surgery

However, no obvious cause can be found in many cases.

Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) are the first treatment tried.

If medication doesn't work, surgery may be recommended. Chronic effusive pericarditis can be treated with a surgical technique called a pericardiocentesis.

During a pericardiocentesis, a thin plastic tube known as a catheter is passed through the chest and guided into the pericardium. The catheter then drains away the excess fluid.

local anaesthetic is used to numb the skin of your chest so you will not feel any pain during the procedure.

Chronic constrictive pericarditis

It is estimated that 1 in 10 people with a history of acute pericarditis will go on to develop chronic constrictive pericarditis.

The most common symptom of chronic constrictive pericarditis is shortness of breath.

Other symptoms include:

  • fatigue
  • abdominal pain and swelling
  • nausea and vomiting

Possible causes of chronic constrictive pericarditis include:

  • infections – most often bacterial infections, such as tuberculosis
  • complications of radiotherapy
  • damage or injury that occurs during surgery

However, no obvious cause can be found in most cases.

Chronic constrictive pericarditis tends not to respond well to medication, and surgery to remove the pericardium (pericardiectomy) is usually the only cure.

However, this type of surgery carries a 1 in 20 risk of causing death, so surgery would only usually be recommended if your symptoms were having a significant adverse effect on your quality of life.

Cardiac tamponade

In a very small number of cases, inflammation of the pericardium can lead to a large build-up of fluid inside the pericardium. The extra fluid puts the heart under pressure, which makes it unable to pump blood around the body effectively. This is known as cardiac tamponade.

Cardiac tamponade is a potential complication in all cases of pericarditis, but is more common in cases where pericarditis has been caused by tuberculosis or cancer.

If the heart cannot pump blood at the normal level, blood pressure can drop and cause:

  • light-headedness
  • blurred vision
  • palpitations
  • confusion
  • nausea
  • general weakness
  • a temporary loss of consciousness

These symptoms can develop very quickly, sometimes within minutes.

Cardiac tamponade is life-threatening and requires emergency treatment. If you have a history of pericarditis and develop the symptoms listed above, call Emergency and ask for an ambulance.

Cardiac tamponade is usually treated with a pericardiocentesis.

 

Source http://www.nhs.uk/Conditions/Pericarditis/Pages/Introduction.aspx

Germs live everywhere. You can find germs (microbes) in the air; on food, plants and animals; in soil and water — on just about every other surface, including your body.

Most germs won't harm you. Your immune system protects you against infectious agents. However, some germs are formidable adversaries because they're constantly mutating to breach your immune system's defenses. Knowing how germs work can increase your chances of avoiding infection.

Infectious agents come in a variety of shapes and sizes. Categories include:

  • Bacteria
  • Viruses
  • Fungi
  • Protozoa
  • Helminths

Bacteria

Bacteria are one-celled organisms visible only with a microscope. They're so small that if you lined up a thousand of them end to end, they could fit across the end of a pencil eraser.

Not all bacteria are harmful, and some bacteria that live in your body are helpful. For instance, Lactobacillus acidophilus — a harmless bacterium that resides in your intestines — helps you digest food, destroys some disease-causing organisms and provides nutrients.

Many disease-causing bacteria produce toxins — powerful chemicals that damage cells and make you ill. Bacteria cause diseases such as:

  • Strep throat
  • Tuberculosis
  • Urinary tract infections

Viruses

Viruses are much smaller than cells. In fact, viruses are basically just capsules that contain genetic material. To reproduce, viruses invade cells in your body, hijacking the machinery that makes cells work. Host cells are often eventually destroyed during this process.

Viruses are responsible for causing numerous diseases, including:

  • AIDS
  • Common cold
  • Ebola hemorrhagic fever
  • Genital herpes
  • Influenza
  • Measles
  • Chickenpox and shingles

Antibiotics have no effect on viruses.

Fungi

There are many varieties of fungi, and we eat quite a few of them. Mushrooms are fungi, as is the mold that forms the blue or green veins in some types of cheese. And yeast, another type of fungus, is a necessary ingredient in most types of bread.

Other fungi can cause illness. One example is candida — a yeast that can cause infection. Candida can cause thrush — an infection of the mouth and throat — in infants and in people taking antibiotics or who have an impaired immune system. Fungi are also responsible for skin conditions such as athlete's foot and ringworm.

Protozoa

Protozoa are single-celled organisms that behave like tiny animals — hunting and gathering other microbes for food. Many protozoa call your intestinal tract home and are harmless. Others cause diseases, such as:

  • Giardia
  • Malaria
  • Toxoplasmosis

Protozoa often spend part of their life cycle outside of humans or other hosts, living in food, soil, water or insects. Some protozoa invade your body through the food you eat or the water you drink. Others, such as malaria, are transmitted by mosquitoes.

Helminths

Helminths are among the larger parasites. The word "helminth" comes from the Greek for "worm." If this parasite — or its eggs — enters your body, it takes up residence in your intestinal tract, lungs, liver, skin or brain, where it lives off your body's nutrients. Helminths include tapeworms and roundworms.

There's a difference between infection and disease. Infection, often the first step, occurs when bacteria, viruses or other microbes that cause disease enter your body and begin to multiply. Disease occurs when the cells in your body are damaged — as a result of the infection — and signs and symptoms of an illness appear.

In response to infection, your immune system springs into action. An army of white blood cells, antibodies and other mechanisms goes to work to rid your body of whatever is causing the infection. For instance, in fighting off the common cold, your body might react with fever, coughing and sneezing.

What's the best way to stay disease-free? Prevent infections. You can prevent infection through simple tactics, such as washing your hands regularly, being careful with food and water, getting vaccinations, and taking appropriate medications.

  • Hand-washing. Often overlooked, hand-washing is one of the easiest and most effective ways to protect yourself from germs and most infections. Wash your hands thoroughly before preparing or eating food, after coughing or sneezing, after changing a diaper, and after using the toilet. When soap and water aren't available, alcohol-based hand-sanitizing gels can offer protection.
  • Vaccines. Vaccination is your best line of defense for certain diseases. As researchers understand more about what causes disease, the list of vaccine-preventable diseases continues to grow. Many vaccines are given in childhood, but adults still need to be routinely vaccinated to prevent some illnesses, such as tetanus and influenza.
  • Medicines. Some medicines offer short-term protection from particular germs. For example, taking an anti-parasitic medication might keep you from contracting malaria if you travel to or live in a high-risk area.

Seek medical care if you suspect that you have an infection and you have experienced any of the following:

  • An animal or human bite
  • Difficulty breathing
  • A cough lasting longer than a week
  • Periods of rapid heartbeat
  • A rash, especially if it's accompanied by a fever
  • Swelling
  • Blurred vision or other difficulty seeing
  • Persistent vomiting
  • An unusual or severe headache

Your doctor can perform diagnostic tests to find out if you're infected, the seriousness of the infection and how best to treat that infection.

 

Source: http://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/ART-20045289?p=1

Мазмұны

Туберкулез дегеніміз не?

Аурудың симптомдары қандай?

Дәрігер науқасты туберкулезге қалай тексереді?

Туберкулездің белсенді екендігін қалай білуге болады?

Туберкулез қалай емделеді?

Туберкулезді емдеу үшін қандай препараттар қолданылады?

Дәрігерге қойылатын сұрақтар

 

Туберкулез дегеніміз не?

Туберкулез (ТБ) –бактериялардан туындаған инфекциялық ауру. Әдетте, туберкулез кезінде өкпе зақымданады, бірақ, үрдіс буындарға, несепқапқа, омыртқа бағанына, миға, және дененің басқа бөліктеріне тарауы мүмкін.

ТБ екі түрі болады:

  • Жасырын немесе белсенді емес туберкулез: организмде бактериялар болғанымен, аурудың симптомдары туындамайды. ТБ бұл түрі жұқпалы емес.
  • Белсенді туберкулез: организмде бактериялар болады және симптомдары туындайды. Науқас инфекция көзі болып, қоршаған адамдарға жұқтыруы мүмкін.

 

Аурудың симптомдары қандай?

Туберкулез белсенді болмаса, аурудың ешқандай симптомдары болмайды. Белсенді  туберкулездің симптомдары:

  • 3 аптадан артық уақытқа созылатын, кейде қан қақырығы болатын жөтел 
  • Кеудедегі ауырсыну
  • Қызба
  • Шаршау
  • Жоспарланбаған салмақ жоғалту
  • Тәбетті жоғалту
  • Қалтырау және түнгі тершеңдік.

 

Туберкулез буынды зақымдаса, артритке ұқсайтын ауырсыну пайда болуы мүмкін. Туберкулез несепқапты зақымдағанда несеп шығаруда ауырсыну  және несепте қан байқалуы мүмкін.   Омыртқа бағанының туберкулезі арқада ауырсыну пайда болуымен және аяқтың салдануымен сипатталады. Мидың туберкулезі бас ауыруын, жүрек айнуын және мидың зақымдануын (емделмесе) туындатады.

 

Дәрігер науқасты туберкулезге қалай тексереді?

Көпшілік жағдайда туберкулезді анықтау кеуде қуысының шолу рентгенографиясы және қарап,  тексерумен жүргізіледі. Оның барысында туберкулездің белсенділігі анықталып, басқа адамдарға жұқтыруға қабілеттілік анықталады.

 

Туберкулездің белсенді екендігін қалай білуге болады?

Туберкулез бактериялары  организмде  болуы мүмкін, бірақ науқас ол туралы білмеуі мүмкін. Дегенмен, белсенді туберкулезде аурудың симптомдары көрініс береді.

Белсенді туберкулезбен ауырған адам, толық емдеу курсын өткеннің өзінде өмір бойы ұдайы медициналық тексеруден өтіп, кеуде қуысының рентгенін түсіріп отыруы қажет, қайтадан туберкулезге шалдықпауы туралы сенімді болуы тиіс.

 

Туберкулез қалай емделеді?

Туберкулезді емдеу үшін антибиотиктер тағайындалады. Дәрілік препараттарды таңдау жасқа, денсаулық жағдайына, туберкулез үрдісінің түріне (белсенді немесе белсенді емес), сондай-ақ, ТБ дәрілік препараттарға тұрақтылығына (препараттардың барлығы емдеуге жарамды емес) байланысты болады.

Туберкулезден препараттарды 6-9 ай бойы қабылдау қажет. Дәрігер қанша уақыт бойы ішу қажеттігін айтады. Дәрігердің нұсқауын мұқият орындау қажет. Ұмытпау үшін дәріні көрінетін жерде ұстаған жөн. Күнделікті бір уақытта қабылдаған жөн. Қабылдауды өткізіп алмау, тоқтатпай қабылдау қажет. Олай болмаса, ауру емдеуге көнбеуі мүмкін.

 

Туберкулезді емдеу үшін қандай препараттар қолданылады?

Туберкулезді емдеудің кең таралған дәрілік препараттары:

  • Изониазид
  • Рифампицин
  • Этамбутол
  • Пиразинамид

 

Дәрігердің ұсынысына сай осы дәрілердің бірін немесе бірнешеуін қабылдау қажет. Олардың әдетте, жанама әсерлері жоқ. Дегенмен, туберкулезге қарсы препараттар бауырды зақымдауы мүмкін. Күрделі жанама әсерінің тізімі төменде келтіріледі.

Бұл дәрілерді қабылдауда алкогольді немесе ацетаминофенді тұтынуға тыйым салынады. Олар бауырда мәселелер пайда болу қаупін арттырады. Кез келген басқа дәрілерді қабылдауда дәрігермен кеңесу қажет, себебі, антибиотиктермен бірге қабылдауда жанама әсерлері пайда болуы мүмкін.

Емдеу курсын өтуде дәрігер науқасты ай сайын бақылайды. Мысалы, дәрігерге тексерілу, рецепт алу және препараттардың жанама әсері болуын тексеру үшін көрінесіз.

Туберкулезге  қарсы препараттардың жанама әсерлері сирек болғанымен, олар күрделі болуы мүмкін. Келесі сипмтомдардың бірі пайда болса, шұғыл түрде дәрігерге көріну қажет:

  • Жүрек айнуы
  • Құсу
  • Іштегі ауырсыну
  • Көрудің айқын болмауы немесе дальтонизм
  • Несеп қошқыл-кофе түсті
  • Қызба, 3 күннін артық
  • Сары ауру (тері мен көздің ағының сарғаюы)

 

Дәрігерге қойылатын сұрақтар

  • Туберкулез қалай жұғады?
  • Ауруханада жұмыс істеймін. Менеджерге ауруханада туберкулезді жұқтырған болуым мүмкін екендігін айтуым қажет пе?
  • Қандай емдеу маған жарамды?
  • Туберкулездің белсенді түрімен ауыруым мүмкін бе?
  • Егер симптомдарым нашарласа, қашан дәрігерге көрінуім қажет?
  • Отбасымның қасында болуым қауіпсіз бе?
  • Жөтелді жеңілдетуім үшін дәрілік препарат бар ма?
  • Басқа дәрілерді қабылдаймын. туберкулезге қарсы емдеуде қандай препараттарды бірге қабылдау қауіпсіз болады?
  • Дәрігерге қаншалықты жиі көрінуім қажет?
  • Туберкулезді емдеп жазу мүмкін бе?

What is tuberculosis?

Tuberculosis (say: too-burr-cue-low-sis), also called TB, is an infection caused by bacteria. Tuberculosis usually affects the lungs, but it can spread to the joints, bladder, spine, brain and other parts of the body.

 There are 2 types of TB:

  • Latent or Inactive TB: The bacteria are present in your body but are not making you sick or contagious; you are not able to spread the disease.

  • Active TB: The bacteria are present and are causing symptoms; you may be able to spread the disease.

 

What are the symptoms of tuberculosis?

You won’t have any symptoms of tuberculosis unless you have active TB. The symptoms of active TB include:

  • Cough that lasts 3 weeks or longer, sometimes bloody
  • Chest pain
  • Fever
  • Fatigue
  • Unintended weight loss
  • Loss of appetite
  • Chills and night sweats

If TB affects your joints, you may develop pain that feels like arthritis. If TB affects your bladder, it may hurt to go to the bathroom and there may be blood in your urine. TB of the spine can cause back pain and leg paralysis. TB of the brain can cause headaches, nausea and brain damage (if left untreated).

 

How can my doctor check for tuberculosis?

The most commonly used method to check for tuberculosis is the PPD skin test. A PPD skin test is also called a Mantoux test. If you have a positive PPD, it means you have been exposed to a person who has tuberculosis and you have been infected with the bacteria that cause the disease.

If your PPD skin test is positive, you will likely have a chest X-ray and a physical exam to find out whether you have active TB and are currently contagious and able to spread the disease to other people.

It usually takes only a few days to tell whether you're contagious. Most people with a positive skin test are not contagious.

 

If I have a positive PPD test, do I have active tuberculosis?

Usually not. A person can be infected with the bacteria that cause tuberculosis but not actually have active tuberculosis. Of the people who are infected with the bacteria that cause tuberculosis, only a few (about 10%) go on to develop active TB.

Healthy people who get infected with the tuberculosis bacteria are often able to fight off the infection and do not develop active TB. The bacteria are dormant (inactive) in their lungs. If the body is not able to contain the infection and the bacteria continue to grow, active tuberculosis develops.

 

Would I know if I developed active tuberculosis?

There is a slight chance you might not know that you have developed active tuberculosis. Tuberculosis bacteria can grow in your body without making you feel sick. However, most people who have active tuberculosis experience symptoms.

If you develop active tuberculosis, you will need to be monitored medically (regular checkups and probably some chest X-rays) for the rest of your life to make sure you stay free of the tuberculosis disease, even after you have taken the full course of tuberculosis medicine.

 

How is tuberculosis treated?

Tuberculosis is treated with antibiotic medicine. The medicine(s) your doctor recommends will depend on your age, your health, whether your TB is active or latent, and whether your TB is drug resistant (meaning that certain medicines won’t work on it).

You will need to take your TB medicine(s) for 6-9 months. Your doctor will tell you exactly how and when to take your medicine, and for how long. It is very important that you follow your doctor’s instructions carefully. Keep your medicine in a place where you will always see it. Take it at the same time every day. Don’t skip doses or stop taking your medicine. This could make your TB harder to treat.

 

What medicines are used to treat tuberculosis?

Common medicines used to treat tuberculosis include the following:

  • Isoniazid
  • Rifampin
  • Ethambutol
  • Pyrazinamide

Depending on your doctor’s recommendations, you may take 1 or more of these medicines. These medicines do not usually cause side effects. However, TB drugs can damage your liver. See the box below for a list of serious side effects.

Don't drink alcohol or take acetaminophen (one brand name: Tylenol) while taking  TB drugs. Alcohol and acetaminophen can increase the risk of liver problems. Always check with your doctor before you take any other medicine because some drugs interact with TB drugs and can cause side effects.

While taking these medicines, your doctor may want to monitor you every month. For example, you may need to visit your doctor for tests, to get another prescription, and to check for any side effects or problems.

 

Although side effects from tuberculosis medicine are not common, they can be serious. Call your doctor immediately if you have any of these symptoms:

  • Nausea
  • Vomiting
  • Abdominal pain, tenderness or soreness
  • Blurry vision or color-blindness
  • Dark (coffee-colored) urine
  • Fever that lasts 3 days or longer
  • Jaundice (the yellowing of the skin and the whites of the eyes)

 

Содержание

Что такое туберкулез?

Каковы симптомы заболевания?

Как врач обследует пациента на туберкулез?

Как я могу узнать активный ли у меня туберкулез?

Как лечится туберкулез?

Какие лекарственные препараты применяются для лечения туберкулеза?

Вопросы, которые вы можете задать врачу

 

Что такое туберкулез?

Туберкулез (ТБ) - это инфекционное заболевание, вызванное бактерией. Обычно при туберкулезе поражаются легкие, но процесс может распространиться на суставы, мочевой пузырь, позвоночник, головной мозг и другие части тела.

Существует два типа ТБ:

  • Латентный или неактивный туберкулез: Бактерии присутствуют в вашем организме, но не вызывают появление симптомов заболевания. При данном типе ТБ вы незаразны.
  • Активный туберкулез: Бактерии присутствуют в организме и вызывают симптомы. Вы можете быть источником инфекции и заражать окружающих.

Каковы симптомы заболевания?

Если туберкулез неактивен, у вас может не быть никаких симптомов заболевания. К симптомам активного туберкулеза относятся:

  • Кашель, длящийся более 3 недель, иногда сопровождающийся кровохарканьем 
  • Боль в груди
  • Лихорадка
  • Усталость
  • Незапланированная потеря веса
  • Потеря аппетита
  • Озноб и ночная потливость

Если туберкулез поражает суставы, у вас может появиться боль, напоминающая артрит. При поражении туберкулезом мочевого пузыря может возникнуть боль при мочеиспускании и появление крови в моче. Туберкулез позвоночника характеризуется возникновением боли в спине и паралича ног. Туберкулез головного мозга может вызвать головные боли, тошноту и повреждение мозга (при отсутствии лечения).

Как врач обследует пациента на туберкулез?

В большинстве случаев диагностика туберкулеза проводится на основании обзорной рентгенографии органов грудной клетки и медицинского осмотра, который помогает выяснить, есть ли у вас активный туберкулез, и способны ли вы в настоящее время заразить других людей.

Как я могу узнать активный ли у меня туберкулез?

Бактерии туберкулеза могут обитать в вашем организме, и при этом вы можете не знать, что больны. Тем не менее, в большинстве случаев у людей с активным туберкулезом имеются симптомы заболевания.

Если вы заболеете активной формой туберкулеза, даже после прохождения полного курса лечения вам в течение всей жизни будет необходимо регулярно проходить медицинские осмотры, снимать рентген грудной клетки, чтобы быть уверенным в том, что вы вновь не заболели туберкулезом.

Как лечится туберкулез?

Для лечения туберкулеза назначаются антибиотики. Выбор лекарственных препаратов будет зависеть от вашего возраста, состояния здоровья, формы туберкулезного процесса (активная или неактивная), а также от того, является ли ваш ТБ устойчивым к лекарственным препаратам (это означает, что не все препараты подходят для его лечения).

Препараты от туберкулеза необходимо принимать в течение 6-9 месяцев. Врач подробно расскажет вам, как, когда и в течение какого времени принимать лекарство. Очень важно тщательно следовать всем инструкциям врача. Храните лекарство в месте, где вы всегда будете его видеть. Принимайте его в одно и то же время каждый день. Не пропускайте и не прекращайте прием препаратов. Это может привести к тому, что ваше заболевание станет плохо поддаваться терапии.

Какие лекарственные препараты применяются для лечения туберкулеза?

К наиболее распространенным лекарственным препаратам для лечения туберкулеза относятся:

  • Изониазид
  • Рифампицин
  • Этамбутол
  • Пиразинамид

В зависимости от рекомендаций врача вы будете принимать 1 или несколько из этих лекарственных препаратов. Эти препараты, как правило, не вызывают побочных эффектов. Тем не менее, противотуберкулезные препараты могут привести к повреждению печени. Список серьезных побочных эффектов данных препаратов указан ниже.

При приеме этих лекарств запрещается употреблять алкоголь или принимать ацетаминофен. Алкоголь и ацетаминофен могут увеличить риск возникновения проблем с печенью. Перед приемом любых других лекарств всегда консультируйтесь с врачом, так как их сочетание с антибиотиками может способствовать возникновению побочных эффектов.

При прохождении курса лечения врачу необходимо наблюдать за вами каждый месяц. Например, вы можете обратиться к врачу для обследования, получения рецепта и для проверки на наличие побочных эффектов от приема препаратов.

Несмотря на то, что побочные эффекты от противотуберкулезных препаратов встречаются нечасто,  они могут быть серьезными. Незамедлительно обратитесь к лечащему врачу при возникновении у вас любого из следующих симптомов:

  • Тошнота
  • Рвота
  • Боль в животе
  • Нечеткое зрение или дальтонизм
  • Моча темно-кофейного цвета
  • Лихорадка, длящаяся более 3 дней
  • Желтуха (желтушное окрашивание кожи и склер)

Вопросы, которые вы можете задать врачу

  • Как я могу заразиться туберкулезом?
  • Я работаю в больнице. Должен ли я сказать менеджеру, что, возможно, я заразился туберкулезом на работе?
  • Какое лечение мне подойдет?
  • Могу ли я заболеть активной формой туберкулеза?
  • Если мои симптомы ухудшаются, когда я должен обратиться к врачу?
  • Безопасно ли мне находиться рядом с семьей?
  • Есть ли какой-нибудь лекарственный препарат для облегчения кашля?
  • Я принимаю другие лекарства. Какие препараты безопасно сочетать с противотуберкулезной терапией?
  • Как часто мне будет необходимо обращаться к врачу?
  • Можно ли вылечить туберкулез?

Что это такое? Плевральный выпот – это накопление жидкости в плевральной полости, разделяющей легкие и грудную клетку. Основными причинами такого образования жидкости являются воспалительный процесс, сердечная недостаточность, рак и воспаление поджелудочной железы. Плевральный выпот часто наблюдается при туберкулезе легких.

Симптомами плеврального выпота могут быть затрудненное дыхание, боль в груди, кашель без мокроты, повышение температуры.  Если плевральный выпот небольшой, симптомы могут отсутствовать. Большое количество жидкости может препятствовать полному наполнению легкого, вызывая затруднение дыхание.

Диагностика. Врач может диагностировать плевральный выпот во время осмотра и затем подтвердить диагноз с помощью рентгеноскопии груди.

Лечение. Если плевральный выпот незначительный то он не требует врачебного вмешательства. Если лечение требуется, то это может в первую очередь потребовать удаления жидкости с помощью так называемого плевроцентеза – введения иглы в плевральную полость и высасывания жидкости. Полученную таким образом жидкость можно отправить в лабораторию для определения причины её накопления.

 

Что это такое? Перикардит – это воспаление перикарда - мешочка, окружающего и защищающего сердце. Перикардит может стать причиной аномального образования жидкости между перикардием и сердцем (перикардический выпот).

Причина перикардита. Наиболее распространенной причиной перикардита является заражение вирусом. Другой важной причиной является инфаркт миокарда, а также ревматическое поражение сердца. Перикардит может явиться результатом бактериальной инфекции – ревматического поражения сердца, сифилисатуберкулеза, а также заражение простейшими и грибками. Уремия, связанная с накоплением мочевины из-за почечной недостаточности также может вести к перикардиту. Радиотерапиярак и операции  на сердце также могут явиться причиной перикардита.

Симптомами перикардита являются: сильная внезапная боль в центре или с левой стороны груди, которая может распространиться на шею, спину, плечи и руки. Глубокое дыхание, движения или лежание часто усиливают боль. Сидячее положение и наклон вперед могут ослабить боль. 
Другие симптомы – незначительное повышение температуры, общее чувство слабости или усталости, депрессия и незначительное помутнение сознания.

Диагностика перикардита проводится при помощи электрокардиографии (ЭКГ). Рентгенологическое исследование позволяет установить жидкость в перикарде. Лечение перикардита может включать лекарственные препараты, уменьшающие воспаление и ослабляющие боль, а в случае бактериальной инфекции – антибиотики. Если имеет место скопление жидкости – то рекомендуется ее удалять (дренировать).

Последствия. Перикардит часто проходит, не нанося вреда  сердцу. Однако, если скопление жидкости при перикардите происходит быстро, то давление на сердце редко увеличиваться, вызывая так называемую тампонаду сердца, при которой сердце может отказать. Острый перикардит может оставлять после себя рубцы, которые мешают нормальной сердечной деятельности. Такое состояние называется хроническим констриктивным перикардитом, который часто требует хирургических вмешательств.

 

Бактериальная инфекция – это инфекция, вызванная бактериями. Это широкий спектр заболеваний от банальной кожной инфекции до таких тяжелых болезней, как чума. К бактериальным инфекциям относятся такие как пневмония,менингит, воспаления почек, мочевого пузыря, а также венерические заболевания, такие как сифилис и гонорея.

Помимо бактерий, инфекции могут вызываться вирусами. Бактериальные инфекции в отличие от вирусной часто можно успешно вылечить с помощью антибиотиков. Бактериальные инфекции могут стать следствием прогрессирующей вирусной инфекции, либо инфекция может развиваться независимо. Часто вирусная инфекция осложняется бактериальной. Это происходит тогда, когда  вирусная инфекция принимает более тяжелые формы, или когда инфекция длится более 10 дней - это может означать присоединение бактериальной инфекции.

Cимптомы бактериальной инфекции обусловлены тремя основными механизмами.

  1. Путем образования экзотоксина – химического вещества, который секретируется бактерией (например, при пищевом отравлении ботулиновой палочкой, вызывающей иногда смертельное заболевания ботулизм). 
  2. Выработка эндотоксина – химического вещества, которое высвобождается при разрушении бактерий (например, при тифе, вызываемым тифозной сальмонеллой). 
  3. Развитие повышенной чувствительности к бактерии (например, при туберкулезе, когда повышенная чувствительность развивается по отношению к микобактериям туберкулеза).

    Если от бактериальной инфекции не лечить, она может распространиться на кровоток. Такое состояние называется бактериемия.