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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There are many causes for either acute or chronic pleurisy. Viral infection such as influenza and cold virusesLung infections from bacteria like tuberculosis or parasites like amebiasisPleural effusionsPulmonary embolismAutoimmune diseases, such as lupus or rheumatoid arthritisCollapsed lung—pneumothoraxCancer in the lungHeart diseaseFamilial Mediterranean fever
Symptoms of pleurisy include: Sharp, stabbing pain towards the side and lower part of the chestPain along the shoulders, neck, and abdomenPain during any movement of the chest, such as breathing and coughingDry coughingFeverRapid pulseRapid and shallow breathing
You will be asked 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: Chest x-rayCT scanUltrasound
Your bodily fluids may be tested. This can be done with: Blood testFluid analysis after thoracentesis—removal of lung fluid with a needleBiopsy
of the pleura with video-associated thoracic surgery (VATS)
Your heart's activity may be tested. This can be done with an EKG.
Treatment will depend on the cause of the pleurisy. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Pain relievers, such as acetaminophen and anti-inflammatories, are used to treat the pain. Anti-inflammatories may also relieve symptoms related to inflammation. Some people 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.
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
then steroid treatment will relieve pain.
Pulmonary embolism or pneumothorax may be treated by surgery.
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
and the flu shot, especially if you are elderly, have a chronic illness, or weakened immunity.
Kass SM, Reamy BV. Pleurisy.
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Pleurisy. Cedars-Sinai website. Available at:
http://www.cedars-sinai.edu/Patients/Health-Conditions/Pleurisy.aspx. Accessed February 22, 2017.
Pleurisy. Johns Hopkins Children's Center website. Available at:
http://www.hopkinschildrens.org/pleurisy.aspx. Accessed February 22, 2017.
Pleural effusion. Merck Manual Professional Version website. Available at:
http://www.merckmanuals.com/professional/pulmonary-disorders/mediastinal-and-pleural-disorders/pleural-effusion. Updated September 2014. Accessed February 22, 2017.
What causes pleurisy and other pleural disorders? National Heart, Lung, and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/pleurisy/causes.html. Updated September 21, 2011. Accessed February 22, 2017.
Last reviewed February 2017 by Michael Woods, MD FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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