What is pleurisy?

Pleurisy is inflammation of the tissue that lines the inside of the chest and covers the lungs (pleura). Pleurisy is often caused by an infection, usually a virus. It also can be caused by other health problems, such as pneumonia or lupus. Pleurisy can cause sharp chest pain that gets worse when you cough or take a deep breath.

You may need more tests to find out what is causing your pleurisy. Treatment depends on the cause. Pleurisy may come and go for a few days, or it may continue if the cause has not been treated. Home treatment can help ease symptoms.

The symptoms of pleurisy are chest pain and difficulty breathing. The chest pain usually starts suddenly. People often describe it as a stabbing pain, and it usually gets worse with breathing. The pain:

• May always be present, but it usually gets worse when you breathe in. You may avoid breathing deeply to prevent the pain.
• Usually is on only one side of the chest.
• May extend to a shoulder or the belly.
• Is usually worse when you cough, sneeze, or suddenly move.
• May ease when you hold your breath or press on the painful area.

But this type of chest pain can be caused by conditions that do not affect the pleura, such as chest muscle strain and costochondritis.

If a viral infection is causing your pleurisy, you may or may not have common viral symptoms, such as fever, headache, and muscle aches.

The inflammation of the pleura sometimes causes fluid to build up in the pleural cavity (pleural effusion). You may have less pain after this happens, because the fluid prevents the two layers of the pleura from rubbing together. If there is a large amount of fluid, it may prevent the lung from expanding when you breathe in. This can make it hard to breathe. Other symptoms of pleural effusion include fever, chest pain, and a dry cough.

Pleural effusion may occur without pleurisy in other conditions, such as heart failure or liver or kidney disease.

Treatment depends on what's causing the pleurisy. It may include medicine. For example, bacterial infections need antibiotics, while blood clots may need anticoagulants. You might take medicine to relieve pain. Treatment may include a procedure. For example, if there's fluid around your lungs, the fluid may need to be drained.

Your doctor will do a physical exam. Blood tests, a chest X-ray, or a CT scan may be done to look for the cause of your symptoms. If you have pleural effusion, your doctor may use a needle to remove some fluid from the pleura and test it.

• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Take cough medicine as directed if your doctor recommends it.
• Avoid activities that make the pain worse.

In young, healthy people, an infection of the lower respiratory system by a virus or bacteria may cause pleurisy. Pleurisy usually lasts a few days to 2 weeks. In very rare cases, the virus or bacteria may spread and cause pleurisy in others.

Other causes of pleurisy include air leaking into the pleural cavity from a hole in a lung (pneumothorax), injury to the chest (such as a broken rib), tuberculosis or other infections, or a tumor in the pleura.

Other conditions may also cause pleurisy. These include rheumatoid arthritis, lupus, sickle cell crisis, pulmonary embolism, or pancreatitis. Pleurisy may also develop as a complication of heart surgery.

Pleurisy is swelling (inflammation) of the thin layers of tissue (pleura) covering the lungs and the chest wall.

The outer layer of the pleura lines the inside of the chest wall, and the inner layer covers the lungs. The tiny space between the two layers is called the pleural cavity. This cavity normally contains a small amount of lubricating fluid that allows the two layers to slide over each other when you breathe.

When the pleura becomes inflamed, the layers rub together, causing chest pain. This is known as pleuritic pain.

Pleurisy is sometimes called pleuritis.