Pleurisy

Definition

Pleurisy is inflammation of the lining of the lungs that causes pain when you take a breath or cough.

Alternative Names

Pleuritis; Pleuritic chest pain

Causes

Pleurisy may develop when you have lung inflammation due to infections such as pneumonia or tuberculosis. It may also occur with:

• Asbestos-related disease
• Certain cancers
• Chest trauma
• Pulmonary embolus
• Rheumatic diseases

When you have pleurisy, the normally smooth lining of the lung (the pleura) become rough. They rub together with each breath, and may produce a rough, grating sound called a "friction rub." The health care professional can hear this sound with the stethoscope, or by placing an ear against the chest.

Symptoms

The main symptom of pleurisy is pain in the chest. Some people feel the pain in the shoulder.

Deep breathing, coughing, and chest movement makes the pain worse.

Pleurisy can cause fluid to collect inside the chest cavity. This can make breathing difficult and may cause the following symptoms:

• Coughing
• Cyanosis
• Shortness of breath
• Rapid breathing (tachypnea)

Exams and Tests

The doctor will use a stethoscope to listen to the lungs for abnormal sounds.

The health care provider may perform the following tests:

• CBC
• Thoracentesis
• Ultrasound of the chest
• X-ray of the chest

Treatment

The health care provider can remove fluid in the lungs by thoracentesis and check it for signs of infection.

Treatment depends on what is causing the pleurisy. Bacterial infections are treated with antibiotics. Some bacterial infections require a surgical procedure to drain all the infected fluid.

Viral infections normally run their course without medications. Patients often can control the pain of pleurisy with acetaminophen or anti-inflammatory drugs such as ibuprofen.

Outlook (Prognosis)

Recovery depends on what is causing the pleurisy.

Possible Complications

• Breathing difficulty
• Collapsed lung due to thoracentesis
• Complications from the original illness

When to Contact a Medical Professional

Call your health care provider if you have symptoms of pleurisy. If you have breathing difficulty or your skin turns blue, seek immediate medical care.

Prevention

Early treatment of bacterial respiratory infections can prevent pleurisy.

References

Marx J, et al. Rosens Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002:1005.

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000:497-498.