Overview

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

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

If you have pleurisy, these tissues swell and become inflamed. As a result, the two layers of the pleural membrane rub against each other like two pieces of sandpaper, producing pain when you inhale and exhale. The pleuritic pain lessens or stops when you hold your breath.

Treatment of pleurisy involves pain control and treating the underlying condition.

Symptoms

Signs and symptoms of pleurisy might include:

  • Chest pain that worsens when you breathe, cough or sneeze
  • Shortness of breath — because you are trying to minimize breathing in and out
  • A cough — only in some cases
  • A fever — only in some cases

Pain caused by pleurisy might worsen with movement of your upper body and can radiate to your shoulders or back.

Pleurisy can be accompanied by pleural effusion, atelectasis or empyema:

  • Pleural effusion. In some cases of pleurisy, fluid builds up in the small space between the two layers of tissue. This is called pleural effusion. When there is a fair amount of fluid, pleuritic pain lessens or disappears because the two layers of pleura are no longer in contact and don't rub together.
  • Atelectasis. A large amount of fluid in the pleural space can create pressure, compressing your lung to the point that it partially or completely collapses (atelectasis). This makes breathing difficult and might cause coughing.
  • Empyema. The extra fluid can also become infected, resulting in an accumulation of pus. This is called an empyema. An empyema is often accompanied by fever.

When to see a doctor

Call your doctor right away if you experience unexplained, intense chest pain during breathing. You might have a problem with your lungs, heart or pleura or an underlying illness for which you need prompt medical care.

Causes

A variety of underlying conditions can cause pleurisy. Causes include:

  • Viral infection, such as the flu (influenza)
  • Bacterial infection, such as pneumonia
  • Fungal infection
  • Autoimmune disorder, such as rheumatoid arthritis or lupus
  • Lung cancer near the pleural surface
  • Pulmonary embolism
  • Tuberculosis (TB)
  • Rib fracture or trauma
  • Certain inherited diseases, such as sickle cell disease
  • Certain medications

Jan. 03, 2020
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  3. Viral pleuritis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pulmonary-disorders/mediastinal-and-pleural-disorders/viral-pleuritis?query=Viral%20Pleuritis. Accessed Dec. 4, 2019.
  4. Mason RJ, et al. Pleural effusion. In: Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Dec. 4, 2019.
  5. Kliegman RM, et al. Pleurisy, pleural effusions, and empyema. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Dec 4, 2019.
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