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Pleurisy

What is Pleurisy?

Pleurisy is an inflammation of the pleura. Pleura is the lining of the lungs. Pleurisy is characterized by subsequent pain.

Pleurisy is also called pleuritis and pleuritic chest pain.

What Causes Pleurisy?

Pleurisy be caused by pneumonia, tuberculosis, rheumatic diseases, chest trauma, certain types of cancers, and asbestos-related disease.

The pleural surfaces are normally smooth. A patient with pleurisy will have rough pleural surfaces. The roughness is caused by inflammation. The pleural surfaces rub together with each breath, and may produce a rough, grating sound called a "friction rub". A friction rub can be heard with the stethoscope or an ear held against the patient's chest.

Symptoms of Pleurisy

The main symptom of pleurisy is pain over the chest wall at the site of the inflammation. Pain may also be felt in the shoulder and increases during deep breathing, coughing, and chest movement.

Other symptoms of pleurisy are:

  • Cough
  • Fever
  • Malaise
  • Localized chest pain on the chest wall
  • Chest pain with each breath
  • Chest pain worsened by coughing
  • Chest pain worsened by deep breathing

Complications of Pleurisy

As pleurisy progresses, 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 can compromise breathing and may cause coughing, shortness of breath with rapid breathing, cyanosis, and retractions.

Can Pleurisy be Treated?

Yes. Treatment options will depend on the underlying illness. Bacterial infections are treated with antibiotics. Tuberculosis requires special treatment. Pleural fluid may be removed by thoracentesis, and evaluated for signs of infection. The pain of pleurisy can often be controlled with acetaminophen or anti-inflammatory agents, such as ibuprofen.

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