PPT for TB pleurisy

1. Pleuritis And Pleural Puncture
Name :- Tanu Priya &
Danish khalida Ansari
Group :- 22
Semester :- 8th
Subject:-
Phthisiopulmonology

2. Introduction to Pleuritis and Pleural Puncture
Pleuritis is the inflammation of the pleura, the
pleura, the thin membrane that lines the chest
chest cavity and surrounds the lungs.
Pleural puncture, also known as thoracentesis,
is a procedure to remove fluid or air from the
pleural space for diagnostic or therapeutic
purposes.
Pthiopulmonology is the branch of medicine
that focuses on the diagnosis and treatment of
diseases affecting the pleura and lungs.

3. Causes of Pleuritis
Infections such as pneumonia, tuberculosis, or
tuberculosis, or viral infections can lead to
to pleuritis.
Autoimmune conditions like lupus or
rheumatoid arthritis can cause inflammation of
the pleura.
Trauma, pulmonary embolism, or certain
medications can also trigger pleuritis.

4. Pleural Tb:
Tuberculous pleurisy (TB pleurisy) is a lesion of the pleura by the MTB,
• May be an independent clinical form, or may be a complication of other
forms of tuberculosis,
• M. tuberculosis is the most common etiology in identifying young patients
with pleural effusion in countries with a high prevalence of TB infection,
• In developing countries, the level of TB pleurisy to the total number of
pleurisy varies from 23.4% to 82.4%, in developed countries – from 2.7% to
5.9%.

5. Pathogenesis of Tb Pleuritis:

6. Symptoms of pleural Tb:-
TB pleurisy is more common in men (2:1) at a young age.Usually has an acute onset and is manifested by:
chest pain
• dry cough
general symptoms of TB intoxication (fever, night sweats, weightloss, malaise)
⚫ physical changes
⚫ dullness of percussion sound
weakening of vesicular respiration over the affected area. Characterized by a unilateral lesion (84%) of the
pleura
more on the right, with a large volume of effusion (about60%)
• In 40-85% of cases of TB pleurisy, there is a combined lesion of pulmonary TB

7. Characteristics of pleural fluid inTB pleurisy:
Exudate with predominantlymphocytic pleocytosis (in the initial stagespleocytosis
can be mixed)
⚫ the color is usually strawyellow (in 80% of cases)
pH less than 7.4
protein concentration isincreased
glucose levels are usuallyTow
⚫ the number of mesothelialcells rarely exceeds 5%
in rare cases MBT aredetected in pleural fluid

8. X-ray&CT images of pleuritis:-

9. Diagnosis of Pleural Tb:-
Puncture of the pleural cavity
Bacteriological examination of pleural fluid and sputum⚫ Fastmolecular genetic methods
(XpertMTB/RIF testing,
GenoType MTBDRplus(sl)) rareMTB «Index-TB guidelines.Guidelines on extra-pulmonary
tuberculosis for India. – WHO. –
2016. – 110 p.», strong recommendation, low quality of evidence• Inoculation on solid or liquid
media (Lowenstein-Jensen, BACTECMGIT)
.Microscopy
Common analysis of pleural fluid, pleocytosis• X-ray and computed tomography of the chest
Thoracoscopy of the pleural cavity with a biopsy
• Tuberculin skin testing (Mantoux test)

10. Treatment of Pleuritis
Antituberculous treatment, repeat
thoracentesis, close observation.
Excessive production of exudative material-
May start diffuse thickening the visceral pleura
leading entrapment of the lung, regardless
adequate antituberculous treatment.
• Decortication should be considered

11. Pleural Puncture Procedure
A sterile needle is inserted through the chest
wall into the pleural space under local
anesthesia.
Fluid or air is withdrawn for analysis or to
relieve pressure on the lungs.
Complications of the procedure include
pneumothorax or bleeding, but they are rare.

12. Indications for Pleural Puncture
Establish the cause of a pleural effusion.
Π When an effusion is suspected on physical examination
Confirm by radiographic
Thoracentesis is not generally required in patients:
Small amount of pleural fluid
And a secure clinical diagnosis (eg, with viral pleurisy)
Thoracentesis should be considered in patients with suspected CHF in the following circumstances:
A unilateral effusion is present, particularly if it is left-sided
Bilateral effusions are present, but are of disparate sizes
There is evidence of pleurisy
The patient is febrile
The cardiac silhouette appears normal on chest radiograph

13. Risks and Complications of Pleural Puncture
Pneumothorax, where air leaks into the pleural
space, leading to lung collapse.
Bleeding or infection at the puncture site.
Rarely, injury to nearby structures like the lung
or liver.

14. Conclusion
Pleuritis and pleural puncture are essential
aspects of Pthiopulmonology, focusing on the
diagnosis and management of pleural diseases.
Early recognition and appropriate treatment of
pleuritis can help prevent complications and
improve outcomes.
Pleural puncture is a valuable procedure for
both diagnostic and therapeutic purposes, with
careful attention to minimizing risks and
complications.

15. Thank
you