Description

Pleurisy (PLOOR-ih-see) is a condition in which the pleura — two large, thin layers of tissue that separate the lungs from your chest wall — is inflamed. Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing.

One pleural layer of tissue that wraps around the outside of the lungs. The other pleural layer covering the inner wall of the chest. Between these two layers is a small space (pleural space) that is usually filled with a very small amount of fluid. These layers act as two pieces of satin smooth, gliding past each other, allowing your lungs to expand and contract as you breathe.

If you have pleurisy, these tissues become swollen and inflamed. As a result, the two layers of the pleura lining from rubbing against each other like two pieces of sandpaper. This causes pain when breathing in and out. The pleuritic pain decreases or stops when you hold your breath.

The treatment of pleurisy involves pain control and treating the cause.

Symptoms

The signs and symptoms of pleurisy may include:

  • Pain in the chest that gets worse when breathing, coughing, or sneezing.
  • Shortness of breath, often trying to limit the breathing in and out.
  • Cough — only in some cases.
  • The fever only in some cases.

The pain caused by pleurisy may get worse with movement of the upper part of the body and may spread to the shoulders, or back.

Pleurisy can occur along with pleural effusion, atelectasis, or empyema:

  • Pleural Effusion. In some cases of pleurisy, fluid builds up in the small space between the two layers of fabric. This is called a pleural effusion. When there is a good amount of liquid, pleuritic pain decreases or disappears, because the two layers of the pleura are not in contact and don't rub.
  • Atelectasis. A large amount of fluid in the pleural space can create pressure. This may compress the lung to the point that partially or fully collapse (atelectasis). This makes breathing difficult and can cause coughing.
  • The empyema. The excess fluid in the pleural space can also be infected, resulting in an accumulation of pus. This is called an empyema. The fever often occurs together with an empyema.

When to see a doctor

Call your doctor or seek emergency medical attention immediately if you experience unexplained, severe pain in the chest during breathing. You might have a problem with your lungs, heart, or pleura or an underlying disease that requires prompt medical attention.

Causes

A variety of conditions can cause pleurisy. The causes are:

  • The Viral infection such as the flu (influenza).
  • The bacterial infection, such as pneumonia.
  • The fungal infection.
  • Autoimmune disorders, such as rheumatoid arthritis or lupus.
  • Cancer of the lung, near the surface pleural.
  • The pulmonary embolism.
  • Tuberculosis (TB).
  • Rib fracture or trauma.
  • Certain hereditary diseases, such as sickle cell disease.
  • Certain medicines and recreational drugs.

Risk factors

The risk of pleurisy increases if you get certain infections, like the flu or pneumonia. Some medical conditions, such as lupus, TUBERCULOSIS, and sickle cell disease can also increase your risk. And taking certain medicines, or certain recreational drugs increase the risk of pleurisy.

Diagnosis

Your health care professional is likely to start by asking about your medical history and perform a physical exam that includes listening to the chest with a stethoscope.

To determine if you have pleurisy, and to identify the cause, your healthcare provider may recommend:

  • Blood tests. A blood test can determine if you have an infection. Other blood tests may detect an autoimmune disorder, such as rheumatoid arthritis or lupus. In these conditions, pleurisy can be the first sign.
  • X-ray of the chest. A chest x-ray can show if your lungs are fully inflating or if there is air or fluid between the lungs and the ribs.
  • Computed tomography (CT scan). A ct scan combines a series of X-ray images taken from different angles around your body. Uses computer processing to create cross-sectional images that look as if they were her chest. These pictures can show the condition of the pleura. They can also show if there are other causes of pain, such as a blood clot in the lung.
  • Ultrasound. This imaging method uses high-frequency sound waves to produce precise images of structures within your body. An ultrasound can be used to determine if you have a pleural effusion.
  • Electrocardiogram (ECG or EKG). This heart-monitoring test may be recommended to rule out some problems of the heart as a cause for the chest pain.

Diagnostic procedures

In some cases, your health care provider may remove the fluid and tissue from the pleural space for the test. The procedures may include:

  • The thoracentesis. In this procedure, an agent with local anesthetic (numbing medicine is injected between the ribs to the zone where the liquid has been seen in their imaging studies. Following a needle is inserted through the chest wall between the ribs to remove the fluid for laboratory analysis. The extraction of fluid can also help you breathe better. The needle is usually inserted with the aid of ultrasound guidance.
  • Thoracoscopy. If TB or cancer is suspected, a thoracoscopy — also called pleuroscopy — can be performed. During this procedure, a tiny camera (thoracoscope) is inserted through a small incision in the wall of his chest. This procedure allows a direct view of the inside of your chest to look for any problem or to obtain a sample of tissue (biopsy).

Treatment

The treatment of pleurisy is mainly focused on the underlying cause. For example, if bacterial pneumonia is the cause, an antibiotic may be prescribed to manage the infection. If the cause is a viral infection, pleurisy can go away on its own account.

The pain and inflammation associated with pleurisy is usually treated with nonsteroidal anti-inflammatory drugs (Nsaids) such as ibuprofen (Advil, Motrin IB, others). Occasionally, your healthcare provider may prescribe a steroid medication.

The result of pleurisy treatment depends on the severity of the underlying cause. The early diagnosis and treatment of the condition that caused the pleurisy can help you feel better. Depending on the cause and condition, you can make a full recovery.

Lifestyle and home remedies

These steps can help alleviate the symptoms associated with pleurisy:

  • Take the medication. Take medications as recommended by your healthcare provider to relieve pain and inflammation.
  • Get enough rest. Find the position that causes the least inconvenience to the rest. Even when you start to feel better, be careful not to overdo it.
  • Do not smoke. Smoking can cause more irritation to the lungs. If you smoke and can't stop smoking on your own, ask your medical professional to get help.

Preparing for your appointment

It is likely to start by seeing your primary care provider. However, when you call to make your appointment, you might be urged to seek immediate medical attention if you are having severe, unexplained pain in the chest.

You can bring a friend or family member, if possible, to help you remember the questions and that your health care professional, " he said.

Here's some information to help you prepare for your appointment, and what to expect from your health care provider.

What you can do

Prepare a list that includes:

  • The details of their symptoms, including pain in the chest begins and how far it spreads. Also a list of other signs and symptoms, such as fever, difficulty breathing, or weight loss.
  • Key medical information, including the recent hospitalizations, and any medical condition that you have. Also keep in mind, if the members of the family — especially children — or close friend who has been sick recently.
  • The medications you are taking, including prescription and non-prescription medicines, vitamins, herbs, or other supplements, and dosage.
  • Key personal information, including recent travel, and big life changes. Your health care provider may also be interested in your work history, including a possible exposure to asbestos.
  • Questions to ask your health care provider.

Questions may include:

  • What do you think is the underlying cause of the symptoms?
  • What types of diagnostic tests or procedures do I need if any?
  • What treatment do you recommend it?
  • How soon after the start of treatment can I expect to feel better?
  • There are self-care steps can I take to improve my discomfort?
  • You are recommended to stay home from work or school? For how long?
  • It will help if I quit smoking?
  • Am I at risk of long-term complications of this condition?
  • I have other health conditions. How can I best manage them together?

Do not hesitate to ask questions during your appointment.

What to expect from your health care provider

Be prepared to answer questions to your health care provider might ask, such as:

  • How would you describe your symptoms?
  • What, if anything, seems to improve or worsen your symptoms?
  • Have you been diagnosed with or treated for any other health conditions?
  • Have you traveled recently?
  • Have you been involved in any work, projects or hobbies through the years, that might have been exposed to asbestos?
  • Do you or do you smoke? If so, how much and for how long?
  • Have you recently noticed some swelling and tenderness in joints, or skin rash?

Your healthcare provider will ask additional questions based on your responses, symptoms, and needs. Prepare and anticipate the questions will help you make the most of your appointment time.

Symptoms and treatment of Pleurisy