Pleurisy (Pleuritis) - Treatments

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How is pleurisy treated?

External splinting of the chest wall and pain medication can reduce the pain of pleurisy. Treatment of the underlying disease, of course, ultimately relieves the pleurisy. For example, if a heart, lung, or kidney condition is present, it is treated. Removal of fluid from the chest cavity (thoracentesis) can relieve the pain and shortness of breath. Sometimes fluid removal can make the pleurisy temporarily worse because without the lubrication of the fluid, the two inflamed pleural surfaces can rub directly on each other with each breath.

If the pleural fluid shows signs of infection, appropriate treatment involves antibiotics and drainage of the fluid. If there is pus inside the pleural space, a chest drainage tube should be inserted. This procedure involves placing a tube inside the chest under anesthesia. The tube is then connected to a sealed chamber that is connected to a suction device in order to create a negative pressure environment. In severe cases, in which there are large amounts of pus and scar tissue (adhesions), there is a need for "decortication." This procedure involves examining the pleural space under general anesthesia with a special scope (thoracoscope). Through this pipelike instrument, the scar tissue, pus, and debris can be removed. Sometimes, an open surgical procedure (thoracotomy) is required for more complicated cases.

In cases of pleural effusion that result from cancer, the fluid often reaccumulates. In this setting, a procedure called pleurodesis is used. This procedure entails instilling an irritant, such as bleomycin, tetracycline, or talc powder, inside the space between the pleural layers in order to create inflammation. This inflammation, in turn, will adhere or tack the two layers of pleura together as scarring develops. This procedure thereby obliterates the space between the pleura and prevents the reaccumulation of fluid.

Return to Pleurisy (Pleuritis)

See what others are saying

Comment from: Kristy26, 19-24 Female (Patient) Published: November 07

I was diagnosed with pleurisy last week after getting a chest X-ray from which I thought it was going to be pneumonia. I was diagnosed with bronchitis four weeks prior and was on a ten day antibiotic. I figured pneumonia would be normal for me since I have a long history of getting it around this time and I have asthma as well. I had been having a nonstop sharp shooting pain in my left lung, shoulder and chest region. They gave me a prescription for 600 mg of Motrin but that didn't ease the pain. The pain was reduced a little for a few days and I woke up today with the pain so unbearable all I could do was cry because I feel so hopeless. It's the worst pain I've ever experienced and it's every second of every day.

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Comment from: Arnoldplace, 35-44 Female (Patient) Published: March 28

I woke up with intense shoulder pain that had been creating up all week. I thought it was stress. Then I bent down to feed the cats and I couldn"t catch my breath, my left lung was piercing in pain with every breath. A trip to the emergency room (ER) via ambulance, and it was pleurisy. I was sent home with turbo Motrin that makes me want to eat a house, and I am still in pain when it wears off. It has been 5 days now and I am exhausted and tired of the pain. I am a 44 year old teacher.

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