Definition
Pleurisy is an inflammation of the pleura, the double-layered membrane that surrounds each lung and the rib cage. The pleura protects and lubricates the surface of the lungs as they inflate and deflate within the rib cage. When they become inflamed, the diseased surfaces rub painfully together.
Causes
There are several causes for either acute or chronic pleurisy.
- Viral infection such as influenza and cold viruses
- Lung infections from bacteria like tuberculosis or parasites like amebiasis
- Pulmonary embolism
- Systemic lupus
- After a heart attack such as Dressler’s syndrome
- Asbestos
- Chest injury
- Heart failure
- Inflammatory bowel disease
- Pancreatitis
- Rheumatoid arthritis
- Cancer
- Chronic liver and kidney disease
- Sickle cell disease
- Drug reaction
Risk Factors
Factors that increase your chances of having pleurisy include:
- Infection, injury, or tumor
- An underlying lung condition , such as cystic fibrosis or emphysema
Symptoms
Symptoms of pleurisy include:
- Sharp, stabbing pain towards the side and lower part of the chest
- Pain along the shoulders, neck, and abdomen
- Pain during any movement of the chest, such as breathing and coughing
- Dry coughing
- Fever
- Rapid pulse
- Rapid and shallow breathing
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The pain associated with pleurisy can be enough to diagnose the condition. A stethoscope will be used to listen for abnormal chest sounds, such as a friction rub. The next step is determining the illness that caused the pleurisy.
Images may be taken of your bodily structures. This can be done with:
Your bodily fluids may be tested. This can be done with:
- Blood test
- Fluid analysis after thoracentesis
- Biopsy of the pleura with video-associated thoracic surgery (VATS)
Your heart's activity may be tested. This can be done with an EKG.
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Pain Management
Pain relievers, such as acetaminophen and ibuprofen are used to treat the pain. Some patients can reduce their pain by lying on the painful side, holding a pillow tightly, or wrapping the chest with elastic bandages. Codeine-based cough syrup may be prescribed to treat a painful cough.
Treating the Source of Infection
If pleurisy is the result of a bacterial infection, antibiotics may be prescribed. If it is the result of a viral infection, treatment is to allow the virus to end naturally. If the cause is due to an autoimmune disease such as lupus , then steroid treatment will relieve pain.
If you are diagnosed with pleurisy, follow your doctor's instructions .
If you are diagnosed with pleurisy, follow your doctor's instructions .
Prevention
To help reduce your chances of getting pleurisy, take the following steps:
- Seek early medical attention for conditions that can cause pleurisy.
- Consider getting vaccinated for pneumonia, especially if you are elderly, have a chronic illness, or weakened immunity.
Revision Information
- Reviewer: Tajender S. Vasu, MD; Michael Woods, MD
- Review Date: 05/2013 -
- Update Date: 05/29/2013 -
