| INFRAPULMONARY PLEURISY (Report of 7 cases) |
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Chan S. Lee, Yung H. Kim |
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Department of Internal Medicine, Catholic Medical College, Seoul, Korea |
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| Abstract |
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1. The authors reported 7 cases of Infrapulmonary pleurisy experienced during 3 years from July 1960 to June 1963. The first case was 34year old male. The age of the patients ranged from 20 years to 41 years, 5 cases were male,2 cases were female and 6 cases were right-sided while only 1 case was left-sided. 2. The onset of the diseases were rather acute with the symptoms of the lower chest or hypochondria pain with chill fever in 4 cases and chill fever in 3 cases. The diagnosis were difficult at the beginning, because of no usual evidence of pleural exudation on ordinary P-A view chest X-Ray and puzzled with the several possibility, i.e., liver abscess, subdiaphragmatic abscess or atypical pneumonia etc. 3. concerning on the incidence, although only about 100 cases were reported on the literature available, there were 7 cases encounter out of total 185 cases of pleurisy with effusion for 3 years period at this clinic, if more attention were paid for the proper application of the chest X-ray technique with same side decubitus recumbent position to reveal the fluid level laterally and if more awareness of this type of pleurisy, the authors believe that it will be not infrequent: as previously thought of. 4. the causes of these 7 cases were considered as tuberculous; one confirmed by pleural needle biopsy one by combination of sputum positive pulmonary tuberculous lesion on same side, two by combination of same side pulmonary tuberculosis although without positive sputum and the others 8cases by negation of other causes. 5. As for the treatment of these cases, except 3 cases that left this clinic too soon, performed a few times of thoracentesis and prescribed a daily streptomycin injection and oral steroid therapy for 2-3months and 400-500mg Isoniazid daily for 1 year or more. The clinical courses of these cases were uneventful and gave an impression of more lasting complaints on diaphragmatic pain. 6. The possible mechanism of localized accumulation of fluid in the intrapulmonary space has been speculated by the authors, that is , the injection of the lower margin of the lung into the deep sulcus of the costophrenic sinus may act as like a sealing plug wall to contain the fluid in the space while the patient is standing |
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