PLEURISY

(Pleuritis; Pleurodynia)

 Basic information

description

Pleurisy is an inflammation of the pleura. The pleura is a thin, two-layered membrane that surrounds the lungs and lines the chest wall. When inflamed, the normally smooth membranes rub against each other which leads to the symptoms. In some cases, fluid may build up in the space between the two membrane layers. This is called pleural effusion. Pleurisy can affect all ages.

FREQUENT SIGNS & SYMPTOMS

• Sudden chest pain that worsens with breathing and coughing. The pain varies from vague discomfort that occurs only with deep breathing or coughing to intense, stabbing pain. Pain is usually over the area of pleural inflammation, but it may also occur in the lower chest or abdomen.
• Fever (sometimes).
• Discomfort on moving the affected side.
• Rapid, shallow breathing.
• Breathing difficulty if pleural effusion develops.

causes

Pleurisy can be caused by infection (e.g., bacterial, fungal, or viral), injury, irritation, blood clot, or disease. Sometimes, no cause is found.

risk increases with

• Lung or chest infection (e.g., pneumonia, bronchitis, tuberculosis).
• Blood clot in the lung.
• Injury to the chest or rib fracture.
• Cancer in other parts of the body.
• Collagen vascular disease, such as systemic lupus erythematosus or rheumatoid arthritis.
• Collapse of a part of the lung.
• Kidney, liver, or pancreas disorders.
• Weak immune system due to illness or drugs.
• Smoking.
• Sickle cell disease.

PREVENTIVE MEASURES

No specific preventive measures. Obtain medical treatment for any risk factors listed above to reduce the risk of pleurisy.

expected outcomes

Outcome depends on successful treatment of the disorder causing it. Sometimes, pleurisy symptoms clear completely on their own in 1 to 2 weeks.

possible complications

• Fluid build-up (pleural effusion).
• Pneumonia.
• Scar tissue (adhesions) may form that cause pain and shortness of breath.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask about your symptoms and activities. Medical tests may include blood and pleural fluid studies, x-rays of the chest, and others to diagnose the cause.
• The main treatment is aimed at the underlying cause. Other treatment may help the symptoms of pleurisy.
• Lie with the sore side down, on a firm surface. This will help ease the pain.
• Quit smoking. Find a way to stop that works for you.
• Holding a pillow firmly against the chest wall helps ease the pain when coughing.
• Excess fluid in the pleura may need to be removed. This is done with a needle inserted into the pleura to draw out the fluid.

medications

• You may take nonsteroidal anti-inflammatory drugs, such as aspirin (if over age 18) or ibuprofen, to relieve pain and inflammation.
• Antibiotics, bronchodilators, or stronger pain relievers may be prescribed.

activity

Reduce activity until pain and cough get better. Then resume normal activities gradually.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of pleurisy.
• The following occur during treatment:
  • Fever.
  • Increased pain.
  • Increased breathlessness.
  • Cough that is dry and non-productive.
  • Blue or dark fingernails, toenails, or lips.
  • Blood in the sputum.

Special Notes: