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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.

It may also occur with:

  • Asbestos-related disease
  • Certain cancers
  • Chest trauma
  • Blood clot (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 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
  • Rapid breathing

 

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
  • X-ray of the chest
  • CT scan of the chest
  • Ultrasound of the chest
  • Removal of pleural fluid with a needle (thoracentesis)

 

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.

 
  • Respiratory system overview

    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

    • Respiratory system overview

      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.

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