Pleurisy: Symptoms, diagnosis and treatment
What is pleurisy?
Pleurisy is inflammation of the pleura membrane covering the lungs.
Pleurisy is also known as pleuritis and can cause chest pain with breathing.
Around 2,000 people are admitted to hospital with pleurisy in England each year.
Part of a doctor's diagnosis of pleurisy is listening to the chest to check for a distinctive dry and crunching sound with each breath.
Seek medical advice about pleurisy if symptoms don’t improve or if they get worse after around 3-5 days.
Immediate medical attention is needed if a person with pleurisy symptoms also has a high temperature, is coughing up phlegm or blood, or is experiencing breathing difficulties,
The double-layered pleura protects and lubricates the surface of the lungs as they inflate and deflate within the rib cage. Normally, a thin, fluid-filled gap - the pleural space - allows the two layers of the pleural membrane to slide gently past each other. But when these layers become inflamed, with every breath, sneeze or cough their roughened surfaces rub painfully together like two pieces of sandpaper.
In some cases of pleurisy, excess fluid seeps into the pleural space, resulting in pleural effusion. This fluid build-up usually has a lubricating effect, relieving the pain associated with pleurisy as it reduces friction between the membrane's layers. But at the same time, the added fluid puts pressure on the lungs, reducing their ability to move freely. A large amount of fluid may cause shortness of breath. In some cases of pleural effusion, this excess liquid can become infected.
What causes pleurisy?
Viral infection is probably the most common cause of pleurisy. Other causes include the following:
- Lung infections, such as pneumonia and tuberculosis
- Diseases such as systemic lupus erythematosus (lupus), rheumatoid arthritis, cancer, liver diseases and pulmonary embolism
- Chest injuries
- Drug reactions
Pleurisy and pleural effusion are generally only as serious as the underlying disease causing it. If you have either of these conditions, you may already be undergoing treatment for the underlying disease; if not, seek medical attention immediately.
A pleural effusion can occur without pleurisy. Kidney disease, heart failure and liver disease can cause pleural effusion without inflammation or pain.
What are the symptoms of pleurisy?
Symptoms of pleurisy include the following:
- Severe, fleeting, sharp pain in your chest, often only on one side, when breathing deeply, coughing, moving, sneezing or even talking.
- Severe chest pain that goes away when you hold your breath.
- When pleurisy occurs in certain locations on the lungs, the pain can be felt in other parts of the body such as the neck, shoulder or abdomen.
- Rapid, shallow breathing in response to the pain.
Seek medical advice if you have even a slight fever with these symptoms. Fever could be a sign of a lung infection.