Pleurisy
Pleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.
Causes
Pleurisy may develop when you have lung inflammation due to infection, such as a viral infection, pneumonia, or tuberculosis.
Pneumonia
Pneumonia is inflamed or swollen lung tissue due to infection with a germ. This article covers community-acquired pneumonia (CAP). This type of pneu...
Tuberculosis
Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.
It may also occur with:
- Certain cancers
- Chest trauma
- Blood clot (pulmonary embolus)
Pulmonary embolus
A pulmonary embolus is a blockage of an artery in the lungs. The most common cause of the blockage is a blood clot.
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Symptoms
The main symptom of pleurisy is pain in the chest. This pain often occurs when you take a deep breath in or out, or cough. Some people feel the pain in the shoulder.
Deep breathing, coughing, and chest movement make the pain worse.
Pleurisy can cause fluid to collect inside the chest. As a result, the following symptoms can occur:
- Coughing
- Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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- Pain with deep breaths
Exams and Tests
When you have pleurisy, the normally smooth surfaces lining the lung (the pleura) become rough. They rub together with each breath. This results in a rough, grating sound called a friction rub. Your health care provider may hear this sound with the stethoscope.
Your provider may order the following tests:
-
Complete blood count (CBC)
CBC
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan of the chest
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Ultrasound of the chest
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
ImageRead Article Now Book Mark Article - Removal of pleural fluid with a needle (thoracentesis) for analysis
Thoracentesis
Thoracentesis is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest....
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Treatment
Treatment depends on the cause of the pleurisy. Bacterial infections are treated with antibiotics. Surgery or insertion of a tube in the chest may be needed to drain infected fluid from the lungs. Viral infections normally run their course without medicines.
Taking acetaminophen or ibuprofen can help reduce pain.
Outlook (Prognosis)
Recovery depends on the cause of the pleurisy and your general health condition.
Possible Complications
Health problems that may develop from pleurisy include:
- Breathing difficulty
- Fluid buildup between chest wall and lung
- Complications from the original illness
When to Contact a Medical Professional
Contact your provider if you have symptoms of pleurisy. If you have breathing difficulty or your skin turns blue (cyanosis), seek medical care right away.
Cyanosis
A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.
Prevention
Early treatment of bacterial respiratory infections can prevent pleurisy.
Fenster BE, Lee-Chiong TL, Gebhart GF, Matthay RA. Chest pain. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 38.
McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.