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Alternative names Return to top
Pleuritis; Pleuritic chest painDefinition Return to top
Pleurisy is an inflammation of the pleura, the lining of the lungs, with subsequent pain.Causes, incidence, and risk factors Return to top
Pleurisy may develop in the presence of lung inflammation (pneumonia, tuberculosis), rheumatic diseases, chest trauma, certain cancers, and asbestos-related disease. The main symptom is pain over the chest wall at the site of the inflammation. In some circumstances, the pain may be felt in the shoulder.
The pain is increased by deep breathing, coughing, and chest movement. The normally smooth pleural surfaces -- now roughened by inflammation -- rub together with each breath, and may produce a rough, grating sound called a "friction rub". This can be heard with the stethoscope or an ear held against the patient's chest.
Fluid often accumulates at the site of pleural inflammation. A localized collection of fluid separates the lung pleura from the chest wall pleura, causing the chest pain to disappear even though the illness may be worsening.
Large accumulations of fluid compromise breathing and may cause coughing, shortness of breath with rapid breathing (tachypnea), cyanosis, and retractions.
Symptoms Return to top
Signs and tests Return to top
Physical examination may show abnormal lung sounds:Treatment Return to top
Treatment is directed at the underlying illness. Bacterial infections are treated with appropriate antibiotics. Tuberculosis requires special treatment. Viral infections normally run their course without medications. Pleural fluid may be removed by thoracentesis, and evaluated for signs of infection. The pain of pleurisy can often be controlled with acetominophen or anti-inflammatory agents, such as ibuprofenExpectations (prognosis) Return to top
Recovery depends on the nature of the underlying illness. Recovery from infections of all types is expected with treatment. Recovery from pleurisy caused by malignant disease depends on the type and extent of the illness.Complications Return to top
Calling your health care provider Return to top
Call your health care provider if you experience symptoms of pleurisy. If you have breathing difficulty or the skin turns bluish, seek medical care promptly, possibly in an emergency room.Prevention Return to top
Early treatment of bacterial respiratory infections can prevent pleuritis. No treatments are available for viral respiratory infections with the exception of several drugs for influenza type A. Update Date: 1/27/2004 Updated by: Allen J. Blaivas, D.O., Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospital, Newark, NJ. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |