Introduction
Pleurisy, also known as pleuritis, is an inflammation of the pleura, which are the two large, thin layers of tissue that separate the lungs from the chest wall. These layers are normally smooth and lubricated, allowing the lungs to expand and contract easily during breathing. When the pleura becomes inflamed, it can cause sharp chest pain that worsens with breathing, coughing, or sneezing. Pleurisy is often a symptom of an underlying condition, such as a respiratory infection or autoimmune disease.
Causes
Pleurisy can be caused by a variety of factors, with the most common being viral or bacterial infections. Viral infections, such as influenza or the common cold, are frequent causes. Bacterial infections, such as pneumonia, can also lead to pleurisy. Other causes include:
- Pulmonary embolism (blood clot in the lungs)
- Autoimmune disorders, such as lupus or rheumatoid arthritis
- Chest trauma or injury
- Lung cancer or other tumors
- Fungal infections
- Certain medications
In some cases, the cause of pleurisy may not be identified (idiopathic pleurisy).
Symptoms
The primary symptom of pleurisy is sharp, stabbing chest pain that worsens with breathing, coughing, or sneezing. The pain is often felt on one side of the chest and may radiate to the shoulder or back. Other symptoms may include:
- Shortness of breath
- Dry cough
- Fever (if caused by an infection)
- Rapid, shallow breathing
- Pain that is relieved by holding your breath or pressing on the affected area
Diagnosis
Diagnosis of pleurisy involves a clinical evaluation by a healthcare provider. The provider will listen to the lungs for abnormal sounds, such as a pleural friction rub (a grating or squeaking sound that occurs when the inflamed pleural layers rub together). Diagnostic tests may include:
- Chest X-ray to look for signs of pneumonia, lung tumors, or other abnormalities
- CT scan to provide a more detailed view of the lungs and pleura
- Blood tests to check for infection, autoimmune disorders, or other underlying conditions
- Pleural fluid analysis (thoracentesis) to examine fluid collected from the pleural space
Treatment Options
Treatment for pleurisy focuses on managing the underlying cause and relieving symptoms. Pain management is a key component of treatment and may include:
- Over-the-counter pain relievers, such as ibuprofen or acetaminophen
- Prescription pain medications, if needed
- Rest and avoiding activities that worsen the pain
If the pleurisy is caused by an infection, antibiotics or antiviral medications may be prescribed. For pleurisy caused by autoimmune disorders, treatment may include corticosteroids or other immunosuppressant medications. In some cases, a procedure called thoracentesis may be performed to drain excess fluid from the pleural space.
Prevention
Preventing pleurisy involves reducing the risk of underlying conditions that can cause it. Strategies include:
- Getting vaccinated against influenza and pneumonia
- Avoiding exposure to respiratory infections
- Managing chronic health conditions, such as autoimmune disorders
- Quitting smoking
When to Seek Medical Care
Seek medical attention promptly if you experience:
- Sharp, unexplained chest pain that worsens with breathing
- Shortness of breath
- Fever or chills
- Coughing up blood
- Any other concerning symptoms
Takeaway
Pleurisy is an inflammation of the pleura that causes sharp chest pain, often due to an underlying condition. Early diagnosis and treatment are important for managing symptoms and preventing complications. If you experience symptoms of pleurisy, seek medical care to determine the cause and receive appropriate treatment.