Pleurisy

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Infection of the pleura is the most common cause of pleurisy.
Acute inflammation of the pleura is termed pleurisy, the most common cause of which is infection. Macroscopically, fibrinous exudate is seen over the pleural surfaces, and there is variable exudation of fluid.
Certain infections result in accumulation of pus in the pleural cavity (empyema).
Aspiration of an infected pleural effusion reveals a high-protein exudate.
Neutrophils predominate in acute infections, whereas lymphoid cells predominate in TB.
There is a wide range of causative organisms, mostly spreading from initial lung infection, including
Streptococcus pneumoniae, Haemophilus, Klebsiella, Pseudomonas, and Bacteroides.

Viral infections of the pleura are most commonly due to Coxsackie viruses, echoviruses, and adenoviruses.
The fibrinous exudate of acute pleurisy may become organized to form fibrous pleural adhesions and can lead to fibrous pleural thickening. Calcification may also be seen in the pleura as a result of old tuberculous pleurisy.
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