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The pleural exudate caused by medicines

Epidemiology

The small part of diseases of a pleura are the share of a share of the pleural exudates caused by medicines (on different these from 3 to 10%).

Classification

There are no data.

Etiology and pathogeny of a disease

Medicines which can lead to forming of a pleural exudate:
• furadonin;
• dantrolen;
• Bromocriptinum;
• Procarbazinum;
• methotrexate;
• Practololum.
The pleural exudate can be both the only display, and one of symptoms of others lekarstvenno of the caused diseases of a respiratory organs.
The exudate more often happens transudate, but at some forms of pleural reaction, for example, at influence of a datrolen, exudate to low activity of amylase.

Clinical signs and symptoms of an illness

The following clinical signs are characteristic:
• cough;
• thorax pain.
Feature of the medicinal damage of a pleura caused by nitrofurans consists available 2 — 3-week stage of latency between the beginning of reception of medicines and emergence of the developed disease picture.

The diagnosis and the recommended clinical trials

At physical inspection the dullness in the area of a liquid arrangement, weakening of carrying out breath and voice trembling over a defeat zone attracts attention.
Clinical blood test allows to determine eosinophilia level.
At X-ray inspection the free exudate in a pleural cavity is defined in the presence of more than 100 ml of liquid, at a third of patients focal changes in lungs come to light.

Differential diagnosis

It is necessary to carry out differential diagnosis with other diseases, one of clinical manifestations of which is the pleural exudate:
• malignant new growths;
• tuberculosis;
• pneumonia;
• thromboembolism of branches of a pulmonary artery.

General principles of treatment of a pleural exudate

In most cases there is enough medicine cancellation.
At it is long a persistent pleural exudate glucocorticoids are applied:
Prednisolonum in 15 mg/days before emergence of positive radiological dynamics
In case of the expressed eosinophilia of a dose of GKS increase and carry out therapy according to the schemes described in the article "Pulmonary Eosinophilic Infiltration".
At development of a bronchospasm treatment is carried out according to the scheme described in the article "Bronchospasm and Medicinal Bronchial Asthma".

Assessment of efficiency of treatment

Criterion of efficiency of treatment is positive clinicoradiological dynamics.

Mistakes and unreasonable appointments

Untimely dose adjustment of GKS.

Forecast

The forecast is favorable. In most cases after cancellation of medicine within a week improvement of a state and disappearance of an exudate is observed.

 
"Peritonsillitis and paratonsillar abscess   Pleurisy"