A myringotomy is a medical procedure where a small incision is made in the eardrum to drain the middle ear of any trapped fluid (“myringotomy”). If necessary, a tympanostomy tube may be inserted so the fluid can continue to drain. A myringotomy is usually required when a person has a dysfunctional Eustachian tube (“Myringotomy Information”). A Eustachian tube connects the middle ear to the nasopharynx and is responsible for draining mucus from the middle ear (Tewfik, et al 289). Myringotomies are also used to help treat ear infections that are not responding to antibiotics or other medical treatment (“Myringotomy Information”). Common reasons for persistent nocturnal wheezing and coughing and noisy breathing in infants include inflammation, …show more content…
When the pleura are inflamed, it may cause pain because of the friction between the two layers of the pleura; this pain is likely to be the cause of the restlessness and irritability of the infant. The radiographic examinations show that there is a shadow running parallel to the right cardiac margin, which is determined to be an encapsulated effusion. This pleura effusion is exudative rather than transudative because it was caused by pleural inflammation rather than hydrostatic and oncotic imbalance in the chest The X-rays also show that this exudate is localized anteriorly and inferiorly within the right pleural cavity between the visceral and mediastinal pleurae. The pain associated with pleurisy and the pressure put on lungs because of the exudative effusion may make it extremely hard to breath which is why the infant has been coughing, wheezing and breathing noisily, especially at night (Rubins). Pleurisy is usually caused be a viral infection like the Respiratory Syncytial Virus (RSV). This viral infection explains the low-grade fever and the evidence of an upper respiratory tract infection. The infant is also slightly underweight which may be related the unexplained weight loss sometimes associated with pleurisy. …show more content…
Since the underlying cause is a viral infection, the treatment would just be waiting for the body’s natural defenses to get rid of the virus. This wait can be made more comfortable with the use of an acetaminophen to reduce fever and giving the infant lots of fluid. A pain reliever is also recommended (“How”). However, because the pleurisy is paired with pleural effusion, the pleura must be drained of the fluids to prevent further complications such as a collapsed lung. Thoracentesis is the procedure used to remove excess fluid in the pleural space by inserting a needle or tube. After the procedure a chest X-ray is performed to check if all the excess fluid is gone and if there is any lung damage from the procedure (“Thoracentesis” Lechtzin; “Thoracentesis”