Pleurisy
(Pleuritis)
Medical Author:
Zab Mohsenifar,
MD
Medical Editor:
William C.
Shiel, Jr., MD, FACP, FACR
Medical Revising Author:
George Schiffman, MD
Medical Revising Editor:
Melissa Conrad Stoppler, MD
What is pleurisy?
Pleurisy is inflammation of the linings around the lungs
(the pleura). There
are two layers of pleura: one covering the lung (termed the visceral pleura) and
the other covering the inner wall of the chest (the parietal pleura).
These two layers are lubricated by pleural fluid.
Pleurisy is frequently associated with the accumulation
of extra fluid in the space between the two layers of pleura. This fluid is
referred to as a pleural effusion. Pleurisy is also referred to as pleuritis.
The pain fibers of the lung are located in the pleura.
When this tissue becomes inflamed, it results in a sharp pain in the chest that
is worse with breathing in, aka pleurisy. Other symptoms of pleurisy can include
cough, chest tenderness, and
shortness of breath.
What causes pleurisy?
Pleurisy can be caused by any of the following conditions:
- Infections: bacterial
(including those that cause tuberculosis), fungus, parasites, or
viruses
- Inhaled chemicals or toxic substances: exposure to some cleaning agents like ammonia
- Collagen vascular diseases:
lupus,
rheumatoid arthritis
- Cancers: for example, the
spread of lung cancer or breast cancer
to the pleura
- Tumors of the pleura:
mesothelioma or sarcoma
- Congestion: heart failure
- Pulmonary embolism: blood
clot inside the blood vessels to the lungs. These clots sometimes severely
reduce blood and oxygen to portions of
the lung and can result in death to that portion of lung tissue (termed lung infarction). This, too, can cause
pleurisy.
- Obstruction of lymph
channels: as a result of centrally located lung tumors
- Trauma: rib fractures or
irritation from chest tubes used to drain air or fluid from the pleural cavity
in the chest
- Certain drugs: drugs that
can cause lupus-like syndromes (such as Hydralazine, Procan, Dilantin,
and
others)
- Abdominal processes: such
as pancreatitis, cirrhosis of the liver
- Lung infarction: lung tissue death due to lack of oxygen from poor
blood supply
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