Pleurisy is inflammation of the pleura, the double-layered membrane (covering) that surrounds the lungs. In between the layers of the pleura is a thin layer of fluid. This reduces friction between the two layers, allowing the lungs to expand and contract easily during breathing. If the pleura becomes inflamed, the two layers begin to press against each other, increasing friction and pressure on the lungs. This causes a sharp chest pain when breathing, the most common symptom of pleurisy. Pleurisy usually develops as a complication of a pre-existing infection, such as flu, or an underlying health condition, such as rheumatoid arthritis.
The most common symptom of pleurisy is chest pain when breathing in and out. The pain is:
- usually sharp and stabbing, and
- worse when you breathe deeply, cough, sneeze, move around or apply pressure to your chest.
The pain of pleurisy is often relieved when you take shallow breaths.
Other symptoms of pleurisy include:
- shortness of breath,
- a dry cough, and
- fever and chills.
When to seek medical advice
Signs and symptoms that may show pleurisy is caused by a more serious health condition include:
- a high temperature (fever) of 40°C (104°F), or above,
- a cough that produces thick green or yellow phlegm,
- serious breathing difficulties, and
- a swollen arm or leg (which could indicate a blood clot).
See your doctor or healthcare provider if you have any of these symptoms.
What causes pleurisy?
Pleurisy is a condition that occurs when the pleural membranes, the thin layers of tissue that line the chest cavity and surround the lungs, become inflamed. This inflammation can cause sharp chest pain and difficulty breathing. There are several causes of pleurisy, including:
- Lung infections: Viral or bacterial infections can cause pleurisy. The most common cause of pleurisy is pneumonia.
- Autoimmune diseases: Pleurisy can also occur as a symptom of autoimmune diseases, such as lupus or rheumatoid arthritis.
- Pulmonary embolism: This is a blockage in one of the arteries that supplies blood to the lungs. It can cause pleurisy, along with other symptoms such as shortness of breath and chest pain.
- Cancer: Pleural mesothelioma, a type of cancer that affects the pleural membranes, can cause pleurisy.
- Chest injury: Trauma to the chest, such as a rib fracture or punctured lung, can cause pleurisy.
- Certain medications: Certain medications, such as certain types of chemotherapy drugs, can cause pleurisy as a side effect.
Diagnosing pleurisy typically involves a combination of a physical examination, medical history, and diagnostic tests. The following tests may be used to diagnose pleurisy:
- Physical examination: A doctor will perform a physical examination to assess your breathing and listen to your chest for any signs of fluid or abnormality.
- Chest X-ray: A chest X-ray can help to identify any underlying lung problems, such as pneumonia or fluid buildup, that may be causing the pleurisy.
- Blood tests: Blood tests can help to identify infections, inflammation, or other medical conditions that may be contributing to the pleurisy.
- CT scan: A CT scan can provide more detailed images of the chest and lungs, and can help to identify any abnormalities or conditions that may be causing the pleurisy.
- Pleural fluid analysis: In some cases, a doctor may need to remove a sample of fluid from the pleural space to test for the presence of infection, cancer, or other conditions.
- Echocardiogram: An echocardiogram is a test that uses ultrasound to visualize the heart and can help to identify any underlying cardiovascular problems that may be contributing to the pleurisy.
The treatment of pleurisy depends on the underlying cause of the condition. Some common treatments include:
- Antibiotics: If pleurisy is caused by a bacterial infection, such as pneumonia, antibiotics may be prescribed to treat the infection.
- Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help to reduce inflammation and relieve pain.
- Pain relievers: Over-the-counter pain relievers, such as acetaminophen, can help to relieve pain and reduce fever.
- Steroids: In some cases, a doctor may prescribe corticosteroids to reduce inflammation and swelling in the pleural membranes.
- Drainage of pleural fluid: If there is a buildup of fluid in the pleural space, a doctor may need to drain the fluid using a needle or tube.
- Oxygen therapy: If pleurisy is causing difficulty breathing, oxygen therapy may be necessary to increase the oxygen levels in the blood.
- Treatment of underlying condition: If pleurisy is caused by a more serious underlying condition, such as cancer, appropriate treatment for the underlying condition may be necessary.
Complications of pleurisy
In very rare cases of pleurisy, excess fluid can build up between the layers of the pleura. This is known as pleural effusion. Pleural effusion may relieve chest pain but it can also put a lot of strain on the lungs and cause shortness of breath. The excess liquid can become infected.
Pleural effusion usually clears up when the condition that caused the pleurisy has been successfully treated. If it does not clear up naturally, surgery can be used to drain the fluid.
How long does pleurisy last?
The duration of pleurisy, or inflammation of the pleura (the thin layer of tissue that lines the inner surface of the chest wall and covers the lungs), can vary depending on the underlying cause. In many cases, pleurisy resolves on its own within a few days to a week with proper treatment. However, in some cases, pleurisy can be a complication of a more serious underlying condition, such as pneumonia or lung cancer, and may last for several weeks or months.
It is important to see a doctor if you are experiencing symptoms of pleurisy, such as sharp chest pain or difficulty breathing, as early diagnosis and treatment can help reduce the risk of complications and speed up the recovery process.
What not to do with pleurisy
If you have pleurisy, there are several things you should avoid doing to help reduce your symptoms and promote healing:
- Avoid physical activity: Pleurisy can cause sharp chest pain, especially when you take deep breaths or move your upper body. To reduce pain and prevent further irritation of the pleura, it is important to avoid physical activity and get plenty of rest.
- Avoid smoking: Smoking can irritate the pleura and make your symptoms worse. If you smoke, it is important to quit to help reduce the risk of complications and promote healing.
- Avoid using anti-inflammatory medications: Anti-inflammatory medications, such as aspirin or ibuprofen, can increase the risk of bleeding in the pleural cavity and make your symptoms worse. Talk to your doctor before taking any medications to make sure they are safe for you to use.
- Avoid lying flat on your back: Lying flat on your back can cause fluid to accumulate in the pleural cavity, making it more difficult to breathe. Try to sleep on your side or with your upper body elevated to help reduce fluid buildup.
- Avoid exposing yourself to irritants: Exposure to irritants, such as air pollution, dust, or strong fumes, can irritate the pleura and make your symptoms worse. Try to avoid exposure to these irritants as much as possible.
Remember, everyone’s experience with pleurisy is different, and it is important to work with your doctor to develop a treatment plan that is right for you.
Is pleurisy contagious?
No, pleurisy is not contagious. Pleurisy is an inflammation of the pleura, the thin layer of tissue that lines the inner surface of the chest wall and covers the lungs. It can be caused by a variety of factors, including viral or bacterial infections, lung diseases, autoimmune disorders, or injury to the chest wall.
While pleurisy is not contagious, the underlying causes of pleurisy, such as a bacterial or viral infection, can be contagious. For example, if pleurisy is caused by a bacterial pneumonia, the pneumonia can be spread from person to person through respiratory droplets.