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.
There are many causes for either acute or chronic pleurisy.
- Viral infection such as influenza and cold viruses
- Lung infections from bacteria like tuberculosis or parasites like amebiasis
- Pleural effusions
- Pulmonary embolism
- Autoimmune diseases, such as lupus or rheumatoid arthritis
- Collapsed lung—pneumothorax
- Cancer in the lung
- Heart disease
- Familial Mediterranean fever
Factors that increase your chance of pleurisy include:
- An underlying lung condition, such as cystic fibrosis or emphysema
- Systemic lupus erythematosus (SLE)
- After a heart attack such as Dressler syndrome
- Chest injury
- Heart failure
- Inflammatory bowel disease
- Rheumatoid arthritis
- Chronic liver and kidney disease
- Sickle cell disease
- Drug reaction
Symptoms of pleurisy include:
- Sharp, stabbing pain towards the side and lower part of the chest
- Pain along the shoulders, neck, and abdomen
- Pain during any movement of the chest, such as breathing and coughing
- Dry coughing
- Rapid pulse
- Rapid 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:
Your bodily fluids may be tested. This can be done with:
- Blood test
- Fluid analysis after thoracentesis—removal of lung fluid with a needle
- Biopsy 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.
Treating the Source of Pleurisy
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 SLE, 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 pneumonia vaccine and the flu shot, especially if you are elderly, have a chronic illness, or weakened immunity.
- Reviewer: Michael Woods, MD FAAP
- Review Date: 02/2017 -
- Update Date: 02/18/2014 -