Pleurisy affects the lining between the lungs and chest wall.
Since many cases are mild and resolve themselves without treatment, it is hard to estimate how many people contract pleurisy worldwide.
Contents of this article:
Here are some key points about pleurisy. More information is in the main article.
- Since the invention of antibiotics, pleurisy has become rarer.
- Pleurisy generally lasts from a few days to 2 weeks and often resolves without treatment.
- There are many potential causes of pleurisy, including pancreatitis, lung cancer, and chest wounds.
- The main symptom of pleurisy is a stabbing pain in the chest.
What is pleurisy?
Pleurisy is an infection of the lubricated surfaces between the lungs and the inner chest wall. These are known as pleura.
In a healthy person, the pleura slide smoothly across each other during breathing, leaving a gap called the pleural space. During pleurisy, they rub against one another. This rubbing is the cause of the chest pain associated with pleurisy.
Pleurisy used to be a common complication of bacterial pneumonia, but it is now less common due to the introduction of antibiotics. Pleurisy is only contagious if the underlying infection is also contagious.
The infection can last from a few days up to 2 weeks, depending on the cause and severity of the inflammation.
The main symptom of pleurisy is a sharp, stabbing pain, or a constant ache in the chest. The pain may present on one or both sides of the chest, the shoulders, and the back. It will often get worse with the motion of breathing.
Other symptoms include:
- shortness of breath, or rapid, shallow breathing
- unexplained weight loss
- rapid heartbeat
Pleurisy is often caused by a viral infection. In these cases, symptoms may also include:
A variety of factors can cause pleurisy. In many cases, it occurs as a complication of other medical conditions.
Sickle cell anemia is a potential cause of pleurisy. It is characterized by the presence of red blood cells shaped like sickles.
The most common cause is a viral infection of the lungs spreading to the pleural cavity.
Other causes include:
- bacterial infections, such as pneumonia and tuberculosis
- a chest wound that punctures the pleural cavity
- a pleural tumor
- autoimmune disorders, such as lupus and rheumatoid arthritis
- sickle cell anemia
- pulmonary embolism
- heart surgery
- lung cancer or lymphoma
- a fungal or parasitic infection
- inflammatory bowel disease
- familial Mediterranean fever
- certain medications, such as procainamide, hydralazine, or isoniazid
Infections can sometimes spread, but it is rare to contract pleurisy from another person. It is not contagious.
Pleurisy more often affects people aged over 65 years, those with existing medical conditions, or those who recently experienced a chest injury or underwent heart surgery.
Pleurisy and smoking are not strongly connected. Cigarettes are rarely the direct cause. However, an individual with pleurisy is advised to avoid smoking as it often leads to coughing, and this can increase the pain.
A physician will diagnose pleurisy through a physical examination and by asking about recent and general medical history.
They will search for the cause of the inflammation and rule out other potential triggers of the symptoms.
Sometimes, a person with pleurisy may have a previously unnoticed rib injury or infection.
Simple physical exams will be carried out. Sometimes a doctor can hear the pleural membranes rubbing together using a stethoscope. This sound is known as pleural friction rub.
Chest X-rays will most likely be ordered, and the doctor may take a blood sample to check for autoimmune disorders.
Fluid can build up in the lung in a process known as plural effusion. The doctor might use a needle to take a fluid sample from the pleura for testing. This is called a thoracentesis.
The treatment options for pleural pain include aspirin, ibuprofen, or non-steroidal anti-inflammatory drugs.
Treatment of pleurisy focuses on resolving the cause, such as a virus or other infections. Antibiotics will be prescribed if the inflammation is a result of a bacterial infection.
In some cases, an individual may need to have fluid drained from the pleural cavity through a tube that is inserted into the chest.
Pain can be managed with aspirin, ibuprofen, or non-steroidal anti-inflammatory drugs (NSAIDs). In severe cases, prescription pain and cough medicines may be used, including codeine-based cough syrups.
A blockage in the blood vessel that runs from the heart to the lungs is called a pulmonary embolism. The person with pleurisy may be placed on blood thinners if the physician diagnoses a pulmonary embolism.
If the cause is related to an autoimmune condition, such as lupus, then a rheumatologist will treat the disease with medication.
Treatment depends largely on the cause and the severity of the condition.
Historically, Native Americans have used the pleurisy root to treat pleurisy, also called butterfly weed. There are some safety concerns regarding butterfly weed. Physicians do not recommend its use as there is no evidence that confirms butterfly weed to be an effective cure.
Pleurisy is treatable, and the prognosis is good, but complications can arise if it is left untreated.
The fluid buildup in the pleural cavity may force the two pleural membranes apart and partly relieve the pain produced when they rub together. However, this fluid can sometimes become infected.
The fluid may push against the lung making breathing even more difficult.
Pleuritic chest pain can accompany a pneumothorax after trauma to the chest wall. The collapse of one or both lungs can lead to a buildup of air or gas in the pleural cavity.
The most common symptom is a sudden pain in one side and shortness of breath.
Trauma to the chest wall can cause pleuritic chest pain and blood accumulation in the pleural space. If enough blood accumulates in this area, it can lead to shock from blood loss.
Hemothorax may also lead to hypoxia from the overcrowding of the lung space with blood. In hypoxia, not enough oxygen reaches the tissues.
Early detection and quick management of the underlying condition make it possible to prevent pleurisy.
For example, an early diagnosis and the timely treatment of an infection can prevent fluid from building up in the pleural cavity, or it can minimize levels of inflammation.
Pleurisy can be difficult to diagnose, and it is easily confused with other diseases.
When being treated for any condition, getting plenty of rest and maintaining a healthy diet can help prevent complications such as pleurisy.