Health Library

Pleurisy

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.

Pleura of the Lungs
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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
  • Collapsed lung (Pneumothorax)

Risk Factors

Factors that increase your chances of having pleurisy include:

  • An underlying lung condition , such as cystic fibrosis or emphysema
  • 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

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 or pneumonia sounds. 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 anti-inflammatories are used to treat the pain. Anti-inflammatories may also relieve symptoms related to inflammation. 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 if it is safe to do so.

Treating the Source of Pleurisy

If pleurisy is the result of a bacterial infection, antibiotics may be prescribed. If it is the result of a viral infection, the virus will get better naturally. If the cause is due to an autoimmune disease such as lupus, then steroid treatment will relieve pain. Pulmonary embolism or pneumothorax may be treated by surgery.

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.
  • Ask your doctor if you should get a pneumonia vaccine and the flu shot, especially if you are elderly, have a chronic illness, or weakened immunity.

Resources

American Lung Association
http://www.lungusa.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

Canadian Resources

The Canadian Lung Association
http://www.lung.ca

References

Kass SM, and Reamy BV: Pleurisy. Am Fam Physician. 2007;75:1357-64.
Pleurisy. Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Health-Conditions/Pleurisy.aspx. Accessed May 29, 2013.
Pleurisy. The Merck Manual of Medical Information website. Available at: http://www.merck.com/mmhe/sec04/ch052/ch052b.html. Updated February 2008. Accessed May 29, 2013.