Pleurisy Symptoms and Treatments

Pleurisy is swelling and irritation of the tissues between the lungs and chest wall/rib cage

Pleurisy is swelling and irritation of the tissues between the lungs and chest wall/rib cage. Pleurisy causes chest pain and shortness of breath in an individual. 

Pleura a thin two-layer protective membrane that covers the lungs and lines the inside of the chest wall. The two layers of the pleura are normally lubricated by a thin layer of fluid between them, which helps them slide easily over each other when an individual breathes in and out. Pleurisy is often caused by an infection. The infection may be viral or bacterial. Other common causes include:

• Asbestos-related disease (from home or work exposure)
• Certain cancers (lung, lymphoma, and mesothelioma)
• A blood clot that travels to the lungs
• Rheumatoid arthritis
• Lupus (an autoimmune disorder)
• Reactions to certain medicines or cancer treatments
• Injury to the lungs, for example, from a fractured rib

The most common symptom of pleurisy is chest pain that may start suddenly. The pain is often described as a stabbing sensation that may be severe at times. The pain usually worsens by breathing deeply. Other symptoms of pleurisy may include:

• Rapid, shallow breathing because of pain
• Dry cough
• Extreme weakness
• Chills and fever
• Shortness of breath or respiratory distress due to pleural effusion (large amounts of fluid in the pleural space) making it difficult for the lungs to expand

The following tests are usually helpful for diagnosis of pleurisy:

• Chest X-rays: They may not show pleurisy, but they can show the fluid collecting between the pleural layers. Chest X-rays can also sometimes identify the cause of pleurisy, such as lung disease, tumor, or rib fracture.
• Chest computed tomography (CT) scan: It gives more detailed images and can help in the diagnosis of conditions such as blood clots in the lungs.
• Thoracocentesis: If there is pleural effusion (fluid build-up in the pleural space), the doctor may drain the fluid and send it to be tested to help determine the cause of the pleurisy.
• Other tests: Sputum samples or throat swabs and blood tests help diagnose infectious causes (viruses or bacteria).

Treatment for pleurisy usually involves relieving the pain and treating the underlying cause.

• Chest pain: A physician may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to ease pain and fever.
• Underlying cause: If your pleurisy is caused by a viral infection, it'll usually get better on its own after a few days; however, in few conditions, antiviral drugs may be needed if the symptoms are severe or patients are already in poor health. Bacterial infections may be treated with antibiotics. Patients may need to be admitted to the hospital in very severe cases where the medications are usually given through injections or intravenously.
• Pleural effusion: Sometimes, pleurisy causes a build-up of excess fluid around the lungs called pleural effusion. In this condition, patients may develop shortness of breath. The fluid may need to be drained by inserting a needle or tube through the chest wall under general or local anesthesia.