Pleurisy: Causes, Symptoms, Treatment

Pleurisy, also referred to as pleuritis, is a condition that occurs when pleura gets inflamed and causes severe chest pain.

Pleura are the two large but thin layers of tissues that cover your lungs. These layers of tissues has a fluid inside them that works as a lubricant. When there is an inflammation in the pleura it rubs against each other and causes pain. Generally, chest pain that increases every time you breathe and difficulty in breathing are the two main symptoms of the condition.

Symptoms

Sharp chest pain that increases every time you breathe or cough is the main symptom of pleuritis. However, it may manifest differently to some patients. Here are the other symptoms you may or may not experience:

• Difficulty in breathing
• Constant pain in the chest
• Sudden weight loss
• Pain in the shoulder
• Fatigue
• Headache
• Pain in the muscles

In some cases, you may also experience fever, cough, loss of appetite.

Pleurisy can also bring along other complications such as pleural effusion and empyema. Pleural effusion occurs when there is an accumulation of fluid causing excess pressure on the lungs. This affects the proper functioning of the lungs.

In some cases, individuals with the condition may experience difficulty in breathing but the chest pain may vanish as the fluid accumulation acts as a lubricant. Individuals with the condition may also experience fever and dry cough. This excess accumulation of fluid accompanied by fever and dry cough may cause an infection resulting in empyema.

Causes

There are numerous causes of pleurisy, a viral infection being the most common. Other causes include:

• Fungal infection
• Tuberculosis
• Autoimmune diseases
• Sickle cell anemia
• Pulmonary embolism
• Bronchitis
• Tumor in the chest or lungs
• Pulmonary emboli
• Systemic lupus
• Lung cancer
• Mesothelioma

Additionally, injury to the chest or any complications in heart surgery can also lead to pleurisy. Some medications can also be the cause of pleuritis.

Risk Factors

You are more likely to develop pleurisy if:

• You have any autoimmune diseases
• A history of infections
• You are over 65 years of age
• Family history of the condition
• You have inflammatory bowel disease
• You have asbestosis

Diagnosis

If you have any symptoms associated with pleuritis, consult your doctor. Your doctor may ask you about your symptoms and triggers, medical history, and do a physical examination. Inform your doctor about your recent travel history and life changes. During the physical examination, using a stethoscope your doctor may examine the sound of pleural membranes. Additionally, your doctor may also recommend certain medical tests to confirm the diagnosis:

• X-ray – Your doctor may recommend a decubitus chest X-ray that will help him or her to monitor if there’s any build-up of fluid or inflammation in the lungs.
• Blood tests – Your doctor may recommend blood tests to check for any infection. This may also diagnose any autoimmune disorders.
• CT scan or MRI scan – These tests are helpful to diagnose inflammation and accumulation of fluid in the lungs with the help of images created using high-frequency sound waves.
• Thoracoscopy – In this procedure, your doctor may insert a thin tube-like structure inside your chest cavity that has a camera at one end. Your doctor will monitor the images on a monitor screen, which are captured using the camera. This will help to have a clear view of your chest and lungs from inside.
• Thoracentesis – This procedure is similar to thoracoscopy, but the difference is that your doctor will remove the fluid that accumulated inside your lungs. The fluid can then be sent to the lab for further analysis.

Treatment

Much like in every other diseases, different causative agents will require different approaches to treatment and management. So your doctor will recommend you the treatment based on the cause of your pleuritis.

If the cause of the condition is a viral infection, there’s no special treatment required. The condition will recover on its own. In such cases, your doctor may recommend medications to relieve pain.

If the cause of the condition is a bacterial infection, your doctor may recommend antibiotic medications. Make sure you complete the entire dosage of medications. Not completing the dosage may result to re-infection and worsening the condition.

Likewise, if the cause of the condition is a fungal infection, your doctor will recommend you antifungal medications to treat pleuritis.

If there’s an excess build-up of fluid in your lungs, your doctor may recommend a surgical procedure. This procedure is called thoracentesis. In this procedure, your doctor will insert a thin needle in your lungs to remove the accumulated fluid. This will then be sent to the laboratory for further analysis.

Aside from the above medications, your doctor may prescribe cough syrup and painkillers to treat cough and relieve pain.

Adequate rest and sleep is also necessary to alleviate the symptoms.

It is important to treat the condition as soon as it is diagnosed. If the condition is left untreated, it may cause severe complications such as atelectasis, sepsis, and empyema.

Lifestyle Changes

• You may prevent the complication with the help of adequate rest and by consuming a healthy diet.
• Quit smoking. You may need the help of your doctor and know the right way to quit smoking.
• Take medications as recommended by your doctor. Make sure to complete the entire dosage of the medications even if you were relieved with the symptoms.