What are the symptoms of thoracic diaphragmitis?

Pleural septitis is caused by tuberculosis infection, which initially only threatens the adjacent organs, but if not treated correctly it will extend to the pleural cavity. There are two types of pleurisy. One is dry pleurisy, in which the patient experiences chest pain, and the pain becomes more severe when taking a deep breath or coughing. The other is exudative pleurisy, in which the patient experiences general fatigue, severe sweating, gradual fever, and constant coughing.

1. Causes of thoracic diaphragmitis

Tuberculous pleurisy is caused by the body's hyperreaction to tuberculosis bacteria, which infects the pleura. Tuberculosis bacteria can invade the pleura from the hilar lymph nodes of the primary syndrome through the lymphatic vessels to reach the pleura, or they can spread directly from tuberculosis lesions adjacent to the pleura to the pleural cavity. This disease is more common in young people and children.

2. Classification of thoracic diaphragmitis

(1) Dry pleurisy: When the body's allergic response to tuberculosis bacteria is low, tuberculosis bacteria invade the pleura and dry pleurisy occurs. After treatment, varying degrees of pleural thickening and adhesions are often left behind.

(2) Exudative pleurisy: When the body is highly allergic to tuberculosis bacteria and their metabolites, inflammation develops rapidly, inflammatory cells infiltrate, and the content of serous fibrin increases, forming a large amount of exudate, which becomes exudative pleurisy. Direct infection with tuberculosis bacteria can also cause exudative pleurisy.

3. Clinical manifestations of thoracic diaphragmitis

(1) Dry pleurisy: Due to the close contact and mutual friction between the visceral and parietal pleura, it manifests as a knife-like chest pain on the affected side. The pain is most obvious when taking a deep breath or coughing. The symptoms of tuberculosis poisoning are mild. During physical examination, respiratory movement on the affected side is limited, and pleural friction sounds can be heard during auscultation.

(2) Exudative pleurisy: The symptoms of exudative pleurisy are more obvious than those of dry pleurisy. The patient first experiences fatigue, chills, sweating, general malaise, gradual fever, chest pain, cough, and symptoms aggravated by deep exhalation or activity. As the exudate gradually increases and the lungs are compressed, chest tightness and shortness of breath become more obvious. A large amount of exudate hinders the friction between the parietal and visceral pleura, and the pain is relieved, turning from severe pain to pure pain, distending pain, or gradually disappearing. A large amount of pleural fluid can push organs such as the trachea to the healthy side, fill the intercostal spaces, displace or disappear the apical beat, and cause the diaphragm to descend. When percussed, the upper part of the effusion is dull and the lower part is solid. During auscultation, breath sounds may weaken or disappear, vocal fremitus may weaken, the lungs above the effusion may be compressed, the air volume may be reduced, and bronchial breath sounds may be heard. X-rays can reveal the exact location of the effusion.