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Pleurisy

The lungs and chest cavity are lined with a thin membrane called pleura. With each breath, the pleura slide smoothly against each other, lubricated by a fluid. Pleurisy occurs when the pleura become inflamed and they rub and grate against each other. This causes pain, aggravated by coughing and deep breathing. Also called pleuritis, the inflammation is often caused by respiratory illnesses, including tuberculosis, pneumonia, and asbestos-related diseases. Other causes include viral and bacterial infections and rheumatic conditions like lupus erythematosus.

  • Symptoms include a recent or existing respiratory infection, persistent cough, chest pain, pain when breathing deeply or coughing, malaise, and fever.
  • Sometimes the inflammation can lead to a collection of fluid between the pleura, called pleural effusions. The fluid buildup is either caused by one membrane creating excess fluid or one membrane failing to drain the fluid. Pleural effusions ease the pain by cushioning between the inflamed membranes, leading the patient to believe that the condition is improving when it actually may be getting worse. A large accumulation of fluid can compress the lungs and cause breathing difficulties, coughing, and cyanosis (bluish skin due to lack of blood oxygen). Pleural effusions are commonly caused by primary and metastatic lung cancer.
  • Pleurisy may be detected using a stethoscope to listen to the sound of the pleura scraping against each other, called a “friction rub.” There may also be abnormal breathing sounds like rattling and crackling. Other tests doctors may take include blood tests to check for viral or bacterial infections, x-rays, and a sample of the pleural fluid (thoracentesis).
  • Treatment for pleurisy consists of treating the underlying condition. Antibiotics and anti-inflammatory medication are given for infections while painkillers are prescribed to relieve the pain. The fluid from pleural effusions is drained and medication is given to prevent continued buildup. Treating respiratory infections immediately is key to preventing pleurisy. Immunization against pneumonia and viral and bacterial infections can also help.