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Conhecer Saúde - Empiema pleural
Home | Adultos | Empiema pleural

Empiema pleural

image

Os pulmões são revestidos por uma membrana, a pleura. Entre a pleura e os pulmões há um espaço chamado de cavidade pleural. Este espaço é preenchido por um líquido que facilita os movimentos da pleura e pulmões durante a respiração. Se neste espaço existir ar ou gases, a pessoa sofre de um pneumotórax, se for ocupado por líquido com pus apresenta um empiema pleural.

Origem
O empiema tem geralmente origem numa infecção pulmonar, pneumonia ou abcesso pulmonar. Também pode ocorrer após uma toracocentese (procedimento cirúrgico, cuja finalidade é retirar líquido da cavidade pleural). Em geral, os estafilococos são os agentes causadores da infecção.


Sinais e sintomas
Os sinais e sintomas típicos do empiema são:
- Falta de ar – dispneia
- Febre - hipertermia
- Tosse
- Sensação de mal-estar
- Transpiração em repouso – sudorese
- Dor torácica.
Os doentes crónicos podem apresentar hipocratismo digital. É um sinal característico, onde há um aumento do volume da ponta dos dedos e a base da unha é empurrada para cima. O oxigénio tem dificuldade em chegar a estas zonas, pelo que a cor das extremidades é cianosada (acinzentada).

Diagnóstico
O médico tenta saber através do doente ou familiares os sinais e sintomas, história familiar e pessoal do doente. Após o exame físico, RX ao tórax, TAC e toracocentese, o médico pode confirmar o diagnóstico.

O líquido colhido na toracocentese, é enviado ao laboratório para serem feitas culturas. Desta forma pode-se determinar qual o agente causador do empiema e quais os antibióticos correctos para essa situação.

Tratamento
O tratamento é feito essencialmente com antibióticos e drenagem do empiema.
A maioria dos doentes não ficam com lesões pulmonares, recuperam totalmente.

 

Referencias: Diagnóstico e Terapêutica em Medicina Interna - Otto Miller

Manual Terapêutica Médica - Editora: Lidel