Cholesterol Empyema
Introduction
Introduction to cholesterol empyema Cholesterol-induced empyema is still rare in clinical practice, and it is often caused by improper treatment of tuberculous exudative pleurisy, and the course of disease is prolonged, resulting in long-term non-absorption of pus. The pleural effusion contains a large amount of cholesterol (>1.5g/L). More common in young men and young adults, the course of disease is longer, often found because of chest tightness and chest pain. The right thoracic cavity lesions are more, often wrapped, limited to the lung bottom and the transverse sputum. There may be difficulty breathing when the fluid is accumulated for a long time. People without secondary infection often have no symptoms of infection. basic knowledge The proportion of illness: the incidence rate of middle-aged and elderly people over 50 years old is about 0.05%-0.07% Susceptible people: no special people Mode of infection: non-infectious Complications: Alzheimer's disease dementia
Cause
Cholesterol empyema cause
Cause:
It is a rare chronic pleural effusion lesion, the etiology and pathogenesis are not completely clear, and may be related to abnormal body fat metabolism in vivo or local.
Cholesterol-induced empyema is still rare in clinical practice, and it is often caused by improper treatment of tuberculous exudative pleurisy, and the course of disease is prolonged, resulting in long-term non-absorption of pus.
The course of the disease is long and often found due to examination of chest tightness and chest pain. The right thoracic cavity lesions are more, often wrapped, limited to the lung bottom and the transverse sputum. There may be difficulty breathing when the fluid is accumulated for a long time.
Prevention
Cholesterol empyema prevention
The main cause of the disease is caused by an increase in cholesterol. Cholesterol is a component of blood lipids, which is usually accompanied by an increase in low-density lipoprotein and apolipoprotein levels. Therefore, the main measures for prevention are to improve diet and increase exercise. Eat more fruits and vegetables rich in vitamins. Try to eat less or not eat high-fat greasy food. For obese patients with respiratory infections should be actively treated to avoid aggravation of infection and induce empyema.
Complication
Cholesterol empyema complications Complications Alzheimer's disease dementia
The disease is directly related to the increase of plasma cholesterol and blood lipid levels, so clinical complications are also related to elevated blood lipids. It can directly lead to the hardening of cardiovascular and cerebrovascular and the formation of atherosclerotic plaque. After plaque detachment, vascular occlusion can form obstruction. For intracranial vascular obstruction, it can cause partial paralysis, language barrier, and induce Alz. Hammer disease.
Symptom
Cholesterol empyema symptoms common symptoms pleural effusion chest pain breathing difficulties chest tightness
The pleural effusion contains a large amount of cholesterol (>1.5g/L). It is more common in male young adults, and has a longer course. It is often found because of chest tightness and chest pain. The right thoracic cavity is more common and often wrapped. Limited to the bottom of the lungs and the diaphragm, there may be breathing difficulties when there is a lot of fluid, and there is no infection symptoms in patients without secondary infection.
Examine
Cholesterol empyema examination
Thoracic puncture was obtained with a brown-red viscous liquid with no special odor and no solidification. When swaying, a large amount of scaly sparkling free cholesterol crystals were observed. Microscopic examination revealed flaky or square-shaped cholesterol crystals. The cholesterol content of pleural effusion is generally >3.9mmol/L. However, the blood lipid test was normal. The cytological examination of pleural effusion did not have a positive dysplasia and no clear leukocytosis.
Diagnosis
Diagnosis and identification of cholesterol empyema
Thoracic puncture can be used to determine the cholesterol level of pleural fluid 1.5 ~ 5g / L, can be clearly diagnosed.
There are many similarities between the disease and pulmonary embolism in clinical manifestations, with chest pain and dyspnea as the main clinical manifestations. Secondly, it needs to be differentiated from common infectious empyema. Acute suppurative pleurisy is called empyema, which is caused by purulent pathogen infection in the pleural cavity and accumulation of purulent exudate. Patients often have chest pain, fever, shortness of breath, rapid pulse, general discomfort, loss of appetite and other symptoms, physical examination can be seen in the face, sometimes can not be supine, the affected side of the chest tremor is weakened, percussion is voiced and slamming pain, auscultation breathing The sound weakens or disappears. The blood routine white blood cell count increased and neutrophils increased. X-ray examination varies according to the amount and location of pleural effusion. Ultrasound examination can see the reflected waves of the effusion, can clearly define the effusion range and can make accurate positioning, which helps to determine the puncture site. The diagnosis of empyema must be done by chest puncture and pus.
