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Pleurisy
Pleuritis; Pleuritic chest pain
Pleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.
Causes
Pleurisy may develop when you have lung inflammation due to infection, such as a viral infection, pneumonia , or tuberculosis .
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
Tuberculosis
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
It may also occur with:
-
Asbestos-related disease
Asbestos-related disease
Asbestosis is a lung disease that occurs from breathing in asbestos fibers.
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- Chest trauma
-
Blood clot (
pulmonary embolus
)
Pulmonary embolus
A pulmonary embolus is a blockage of an artery in the lungs. The most common cause of the blockage is a blood clot.
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- 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 make the pain worse.
Pleurisy can cause fluid to collect inside the chest. This can make it harder to breathe. It can cause the following symptoms:
- Coughing
-
Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
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Exams and Tests
When you have pleurisy, the normally smooth surfaces lining the lung (the pleura) become rough. They rub together with each breath. This results in a rough, grating sound called a friction rub. Your health care provider can hear this sound with the stethoscope.
The provider may order the following tests:
-
CBC
CBC
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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X-ray of the chest
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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-
Ultrasound
of the chest
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
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Removal of pleural fluid with a needle (
thoracentesis
)
Thoracentesis
Thoracentesis is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest....
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Treatment
Treatment depends on the cause of 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 medicines.
Taking acetaminophen or ibuprofen can help reduce pain.
Outlook (Prognosis)
Recovery depends on the cause of the pleurisy.
Possible Complications
Health problems that may develop from pleurisy include:
- Breathing difficulty
- Fluid buildup between chest wall and lung
- Complications from the original illness
When to Contact a Medical Professional
Call your provider if you have symptoms of pleurisy. If you have breathing difficulty or your skin turns blue, seek medical care right away.
Prevention
Early treatment of bacterial respiratory infections can prevent pleurisy.
References
Fenster BE, Lee-Chiong T, Gebhart GF, Matthay RA. Chest pain. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 31.
McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 99.
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Respiratory system overview - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system overview
illustration
Review Date: 9/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
