Features of clinical and morphological manifestations of pneumonia complicated by exudative pleuritis in senile patients

Abstract

Globally, pneumonia complicated by exudative pleurisy is often recognised too late and inadequately treated in senile patients.Purpose. To study the clinical manifestations, diagnosis, and treatment of community-acquired pneumonia complicated by exudative pleurisy in the senile.Methods. Archived case histories from the period 2006 – 2022 were used to conduct a comparative study of these clinical manifestations and the outcomes of treatment of community-acquired pneumonia complicated by pleurisy was carried out in 33 patients aged 75 – 88 years and 50 patients aged   18 – 34 years.Results. Acute onset of pneumonia complicated by pleurisy was less common in senile age than in young people (60.6% vs 82.0%; p < 0.05), pneumonia proceeded without an increase in body temperature more often than in young people (24.2% vs 4.0%; p < 0.01), chest pain was less common (60.6% vs 90.0%; p < 0.01), rales in the lungs were heard more often on auscultation (48.5% vs 22.0%; p < 0.05). In the analysis of peripheral blood in senile age, leukocytosis (33.3% vs 66.0%; p < 0.05) and a leftward shift in the leukocyte formula (6.1% vs 24.0%; p < 0.05) occurred less frequently in senile patients. Pneumonia occurred against diseases of cardiovascular system(84.9% vs 8.0%; p < 0.01), gastrointestinal tract (42.4% vs 18.0%; p < 0.05) and urinary system(27.3% vs 4.0%; p < 0.01), and lingered more often in senile people (36.4% vs 10.0%; p < 0.05) than in young ones. In senile age, pneumonia was combined with pericarditis in 6.06% of cases, and in 21.2% it occurred against a background of residual changes after previous respiratory tuberculosis, which was not observed in young age.Conclusion. Antibacterial therapy, taking into account the sensitivity of sputum microflora to drugs, combined with regular aspiration of pleural exudate, made it possible to cure all senile patients without surgical intervention. The severity of residual pleural changes was similar to that in young people.