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    Pleurisy

    Pleuritis; Pleuritic chest pain

    Pleurisy is inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain (usually sharp) when you take a breath or cough.

    Causes

    Pleurisy may develop when you have lung inflammation due to infections such as pneumonia or tuberculosis. This inflammation also causes the sharp chest pain of pleurisy.

    It may also occur with:

    • Asbestos-related disease
    • Certain cancers
    • Chest trauma
    • Pulmonary embolus
    • Rheumatoid arthritis
    • Lupus

    Symptoms

    The main symptom of pleurisy is pain in the chest. This pain often occurs when you take a deep breath in or out, or cough. Some people feel the pain in the shoulder.

    Deep breathing, coughing, and chest movement makes the pain worse.

    Pleurisy can cause fluid to collect inside the chest cavity. This can make breathing difficult and may cause the following symptoms:

    • Bluish skin color (cyanosis)
    • Coughing
    • Shortness of breath
    • Rapid breathing (tachypnea)

    Exams and Tests

    When you have pleurisy, the normally smooth surfaces lining the lung (the pleura) become rough. They rub together with each breath, and may produce a rough, grating sound called a "friction rub." Your health care provider can hear this sound with the stethoscope, or by placing an ear against your chest.

    The health care provider may perform the following tests:

    • CBC
    • CT scan of the chest
    • Thoracentesis
    • Ultrasound of the chest
    • X-ray of the chest

    Treatment

    Treatment depends on what is causing the pleurisy. Bacterial infections are treated with antibiotics. Surgery may be needed to drain infected fluid from the lungs.

    Viral infections normally run their course without medications. Patients often can control the pain of pleurisy with acetaminophen or anti-inflammatory drugs such as ibuprofen.

    Outlook (Prognosis)

    Recovery depends on what is causing the pleurisy.

    Possible Complications

    • Breathing difficulty
    • Collapsed lung due to thoracentesis
    • Complications from the original illness

    When to Contact a Medical Professional

    Call your health care provider if you have symptoms of pleurisy. If you have breathing difficulty or your skin turns blue, seek immediate medical care.

    Prevention

    Early treatment of bacterial respiratory infections can prevent pleurisy.

    References

    Celli BR. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 100.

    Lee-Chiong T, Gebhart GF, Matthay RA. Chest pain. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel’s Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 30.

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      Review Date: 7/23/2011

      Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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