Pleurisy

(Pleuritis)

Pronounced: PLUR-is-see

Definition

The pleura is a layer of tissue around the lungs. The inner layer is attached to the lungs. The outer layer is attached to the chest wall. Pleurisy is swelling of the pleura. It can cause chest pain and make it hard to breathe.

Pleura of the Lungs

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Causes

Pleurisy may be caused by many things including:

  • A viral infection, such as influenza and cold viruses
  • Lung infections from bacteria, such as tuberculosis or parasites like amebiasis
  • Pleural effusions—fluid build up in pleura
  • Pulmonary embolism—a blood clot that travels to the lungs
  • Problems with the immune system, such as lupus
  • A collapsed lung
  • Cancer in the lung
  • Heart disease
  • Familial Mediterranean fever

Risk Factors

Things that raise your risk are:

Symptoms

Pleurisy can cause:

  • Sharp, stabbing pain in the side and lower part of the chest
  • Pain along the shoulders, neck, and belly
  • Pain when you move your chest, such as breathing and coughing
  • A dry cough
  • Fever
  • Rapid heartbeat
  • Rapid and shallow breathing

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. A diagnosis may be made based on the pain. Tests may be done to look for a cause.

Pictures may be taken of your chest. This can be done with:

Other tests may include:

  • Blood test
  • Fluid analysis after thoracentesis—fluid from space outside the lung is removed with a needle for testing
  • Biopsy—sample of pleura is removed for close exam in a lab

Treatment

The cause will need to be treated. This may include medicine or surgery. Treatment will help to manage pain until the swelling has been cleared. Options include:

  • Pain medicine—to help ease pain and inflammation.
  • Lying on the painful side. Holding a pillow tightly. Or wrapping the chest with elastic bandages.
  • Codeine-based cough syrup—to treat a painful cough.

Prevention

Pleurisy may be prevented with:

  • Proper care for health problems that can cause pleurisy.
  • Flu shot and pneumonia vaccine may be helpful. It may be most helpful for older adults. People with chronic illness or have problems with your immune system may also benefit.

RESOURCES:

American Lung Association
http://www.lung.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

The Lung Association
http://www.lung.ca

References:

Kass SM, Reamy BV. Pleurisy. Am Fam Physician. 2007;75(9):1357-1364.
Pleurisy. Cedars-Sinai website. Available at:
...(Click grey area to select URL)
Accessed August 29, 2018.
Pleural effusion. Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated October 2017. Accessed August 29, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 1/14/2019

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