What Is Pleurisy?
The pleura are membranes that surround and contain the lungs and separate them from the chest wall, diaphragm, and heart. Pleurisy (pleuritis) is an inflammation of these membranes. The thin space around the membrane is called the pleural space that is usually filled with a small amount of fluid. When the pleura becomes inflamed, it can cause breathing to be painful and fluid may build up in the pleural space.
What Are Symptoms of Pleurisy?
Symptoms of pleurisy include:
- Chest pain
- Most common symptom of pleurisy
- May be a sharp, stabbing pain, a dull ache, or a burning sensation
- Pain is usually worse when inhaling deeply, coughing, sneezing, or moving
- Pain is less when taking shallow breaths or lying on the painful side
- Cough: may be dry or may contain sputum or blood
- Shortness of breath
- Shallow, rapid breathing
- Fever (depends on the cause)
What Causes Pleurisy?
Causes of pleurisy include:
- Infections from viruses, bacteria, fungi, parasites, or tuberculosis
- Certain cancers such as mesothelioma, lung cancer, pleural tumors, or metastases (cancer that has spread from other parts of the body)
- Hole in the lung (pneumothorax)
- Collagen vascular diseases such as lupus, rheumatoid arthritis, sarcoid disease, or scleroderma
- Injury to the chest such as bruised or broken ribs
- Gastrointestinal disease, such as pancreatitis or peritonitis
- Reactions to certain drugs such as methotrexate (Rheumatrex, Trexall), penicillin, and chemotherapy drugs
- Blood clot in lung (pulmonary embolism)
- Radiation therapy
- Sickle cell disease
- Human immunodeficiency virus (HIV)
- COVID-19 virus
- A complication of heart surgery
Is Pleurisy Contagious?
Pleurisy itself is not contagious, however, infections that can cause pleurisy such as viruses, bacteria, fungi, parasites, or tuberculosis can be.
Bacteria and viruses can be transmitted when people:
- Inhale respiratory droplets released after an infected person coughs or sneezes
- Touch something with droplets on it and then touch their mouth or nose
- Share glasses, plates, or utensils with an infected person
How Is Pleurisy Diagnosed?
Pleurisy is diagnosed with a patient history and physical examination. Testing that may be indicated to either confirm pleurisy or rule out other conditions that cause similar symptoms, may include:
- Chest X-ray
- Computerized tomography (CT) scan
- Electrocardiogram (ECG)
- Echocardiogram (“echo”)
- Pulse oximetry
- Thoracentesis: removal of fluid from around the lung
- Blood tests to check for infection or certain proteins that could indicate a heart attack
What Is the Treatment for Pleurisy?
Pleurisy may go away on its own in some cases, depending on the cause.
Treatment for pleurisy includes:
- Pain relievers
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin), indomethacin (Indocin), or naproxen (Naprosyn)
- Narcotic pain relievers such as codeine, hydrocodone (Vicodin), or oxycodone (Percocet)
- Corticosteroids such as prednisone or dexamethasone
- Antibiotics to treat bacterial infections that cause pleurisy
- Thoracentesis to drain pleural fluid from around the lungs
- Chest tube to drain the air in a pneumothorax or to drain infection
- Blood thinners to dissolve blood clots that cause pain
- Stopping medication that is causing the pain (never stop taking a prescribed medication without first talking to your doctor)
What Are Complications of Pleurisy?
Complications of pleurisy include:
- Pleural effusion (excess fluid buildup in the tissue around the lungs)
- Scar tissue that can cause chronic pain or shortness of breath
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