Pleurisy

What is pleurisy?

Pleurisy is a type of chest pain you may have when the internal lining of your chest wall, called the pleura, is inflamed. The pleura is a thin, two-layered membrane that covers the lungs as well as the inside of the chest wall. Pleurisy is also called pleuritis.

Sometimes, if you have a lot of inflammation, fluid collects in the space between the lungs and chest wall. This space is called the pleural space, and the collection of fluid is called a pleural effusion.

How does it occur?

Pleurisy is a problem that can occur with many different diseases. It may happen when:

• The pleura is irritated by an infection, such as a cold, flu, pneumonia, or tuberculosis.
• Your chest wall is injured.
• Part or all of one of your lungs collapses (a pneumothorax).
• You have a blood clot in a lung.
• You have arthritis, heart failure, or cancer.

The most common cause is a viral infection, such as a cold or flu.

You are at greater risk of having pleurisy if you smoke.

What are the symptoms?

• Pleurisy causes sudden, sharp chest pain when you breathe (especially when you breathe deeply), or when you cough, sneeze, or laugh. The pain is usually better or absent between breaths.
• You may feel short of breath because it hurts to breathe.
• You may have a fever.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and give you a physical exam. Using a stethoscope on your chest, your provider will listen for a rubbing sound when you breathe. You may have one or more of these tests:

• chest X-ray
• blood tests
• thoracentesis, which is a procedure for getting and testing a sample of fluid from your lungs, if you have a pleural effusion.

You may have to spend some time in the hospital while you are being diagnosed, especially if you are short of breath.

How is it treated?

Your healthcare provider may prescribe:

• Medicine for the pain and inflammation, such as ibuprofen, naproxen, acetaminophen, narcotics, steroids, or a combination of these medicines
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and naproxen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
  • Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it.
• Medicine to inhale to help open the airways so you can breathe more easily
• An antibiotic if you have a bacterial infection
• Other medicines or procedures, depending on the cause of the pleurisy

The treatment that is right for you will depend on what is causing the inflammation. Your healthcare provider may want you to return for a checkup and another chest X-ray to make sure the problem has been successfully treated.

How long will the effects last?

How long the effects last depends on the cause of the pleurisy. If the inflammation is caused by a viral infection, the symptoms will usually be gone in a week or two.

How can I take care of myself?

• It is very important to breathe deeply several times an hour when you have pleurisy. When you don't breathe deeply, the lower parts of your lungs can collapse like a tire with a slow leak. When the lungs collapse, you are more likely to develop pneumonia. For example, a good rule of thumb is to take a couple of deep breaths every time a commercial comes on if you're watching TV.
• Work with your healthcare provider to get good pain control. You won't be able to breathe deeply if you have too much pain.
• If you smoke, stop. If someone else in your household smokes, ask them to smoke outside.
• Acetaminophen, ibuprofen, or naproxen may help decrease your pain. Take the medicine according to your healthcare provider’s advice.
• If you were given a prescription for antibiotics, be sure to get it filled right away. Follow the directions exactly. Take the medicine until it is completely gone. Don’t stop taking it just because you feel better.
• Call your healthcare provider if:
  • You have a fever higher than 101.5° F (38.6° C).
  • You have more trouble breathing.
  • You start to have chills, nausea, vomiting, or muscle aches.
  • You have any symptoms that worry you.

What can I do to help prevent pleurisy?

Some cases of pleurisy can be prevented by avoiding or immediately treating the conditions that cause it, such as colds or flu.