PLEURISY

General Information

DEFINITION--Inflammation and irritation of the pleura, a thin, two-layered membrane that lines the lung and chest cavity. Pleurisy is not a disease, but may be a manifestation of many different diseases.

BODY PARTS INVOLVED--Pleura.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Sudden chest pain that worsens with breathing and coughing. The pain varies from vague discomfort that occurs only with deep breathing or coughing to intense, stabbing pain. Pain is usually over the area of pleura inflammation, but it may also occur in the lower chest or abdomen.
• Fever (sometimes).
• Discomfort on moving the affected side.
• Rapid, shallow breathing.
• If fluid develops at the site of inflammation between the two membrane layers, the liquid is called pleural effusion. When this happens, the pleurisy pain usually subsides, but breathlessness worsens.

CAUSES--

Complication of:

• Lung or chest infections, such as pneumonia or tuberculosis.
• Bronchiectasis.
• Collapse of part of the lung.
• Blood clot in the lung.
• Injury to the chest or rib fracture.
• Cancer in other parts of the body.
• Collagen vascular disease, such as systemic lupus erythematosus or rheumatoid arthritis.
• Congestive heart failure.
• Kidney and liver disorders.

RISK INCREASES WITH

• Obesity.
• Smoking.
• Use of immunosuppressive drugs.

HOW TO PREVENT--Obtain medical treatment for the underlying disorder.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies to detect infection or autoimmune disease.
• X-rays of the chest.
• Biopsy (sometimes).
• Examination of pleural fluid (if any).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Pneumonia.
• Lung compression or collapse and impaired breathing from leakage of pleural effusion.
• Scarring and adhesions at the site of inflammation, restricting lung expansion.

PROBABLE OUTCOME--Successful treatment of pleurisy depends on successful treatment of the disorder causing it. Often, symptoms without complications clear completely and spontaneously in 2 weeks.

How To Treat

GENERAL MEASURES--

• For chest pain, wrap the entire chest loosely with 2 or 3 non-adhesive, 6-inch-wide elastic bandages.
• For coughing, use a cool-mist, ultrasonic humidifier to help loosen bronchial secretions so they can be coughed up easily. Clean humidifier daily. Holding a pillow firmly against the chest wall helps facilitate coughing.

MEDICATION--

• Your doctor may prescribe Antibiotics, bronchodilators, or pain relievers after diagnosis of the underlying disorder.
• You may take simple pain relievers, such as acetaminophen or aspirin, to relieve pain if no complicating disorders exist.

ACTIVITY--Reduce activity until pain and fever disappear. Then resume normal activities gradually.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of pleurisy.
• The following occurs during treatment: Fever. Increased pain. Increased breathlessness. Cough that is dry and non-productive. Blue or dark fingernails, toenails or lips. Blood in the sputum.