Pleurisy: Symptoms, diagnosis and treatment
What is pleurisy?
Pleurisy, also called pleuritis, is an inflammation of the pleura, which is the moist, double-layered membrane that surrounds the lungs and lines the inside of the rib cage. The condition can make breathing extremely painful. Sometimes it is associated with another condition called pleural effusion, where excess fluid fills the area between the membrane's layers.
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.
What are the symptoms of pleural effusion?
The symptoms of pleural effusion include:
- Shortness of breath
- A dry cough
Seek medical advice about pleurisy if:
- You are experiencing pleurisy symptoms, particularly if you have not been diagnosed with an underlying disease that could be causing this lung condition; pleurisy and pleural effusion can be symptoms of serious diseases such as pneumonia and lung cancer.
- You experience symptoms accompanied by fever, no matter how slight. You may have a type of infection that requires treatment with antibiotics.