Pleurisy

Pleurisy | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Lungs and airways Pleurisy Pleurisy About pleurisy Causes of pleurisy Treating pleurisy About pleurisy Pleurisy is inflammation of the sheet-like layers that cover the lungs (the pleura). The most common symptom of pleurisy is a sharpchest pain when breathing deeply. Sometimes the pain is also felt in the shoulder. The pain may be worse when you cough, sneeze or move around, and it may be relieved by taking shallow breaths. Other symptoms can includeshortness of breathand a dry cough . Visit your GP if youexperience the above symptoms.Seek immediate medical help if your chest pain is severe, particularly if you also have other symptoms, such as coughing up blood, nausea or sweating. Seeing your GP Pleurisy can usually be diagnosed by studying your symptoms. Your GP can listen to your chest to check for the distinctive dry, crunching sound that suggests you may have pleurisy. Further tests may beneeded to identify the underlying cause of your pleurisy and to assess how severe it is. These can include: blood tests to determine whether you have an infection or an autoimmune condition chest X-rays an ultrasound scan a computerised tomography (CT) scan a biopsy  a small sample of pleural or lung tissue is removed for further testing What causes pleurisy? Most cases are the result of aviral infection (such as the flu ) ora bacterial infection (such as pneumonia ). In rarer cases, pleurisy can be caused by conditionssuch asa blood clot blocking the flow of blood into the lungs (pulmonary embolism)or lung cancer . Pleurisy can affect people of all ages, but people of 65 years and over are most at risk, because theyre more likely to develop a chest infection . Read more about the causes of pleurisy . How is pleurisy treated? Treatment for pleurisy depends on the underlying cause. For example, pleurisy caused by a viral infection will often resolve itself without treatment.However, pleurisy caused by a bacterial infection is usually treated with antibiotics , and people who are frail or already in poor health may be admitted to hospital. Non-steroidal anti-inflammatory drugs (NSAIDs) , such as ibuprofen , are often used to relieve the chest pain associated with pleurisy. If excess fluid builds up between the pleural layers, it may be necessary to drain the fluid to prevent breathing difficulties. Read more about treating pleurisy . Causes of pleurisy Pleurisy is inflammation of the pleura. Its usually caused by another condition, such as an infection, but sometimes no cause can be identified. The pleura are two thin sheets of tissuethat separate the lungs and ribcage. One is attached to the ribcage and the other is attached to the lungs. Between the pleural sheets is a thin layer of liquid that lubricates the pleura, helping to reducefriction when you breathe in and out. When theres inflammation, the surfaces of the two layers can become rough and the fluid can become sticky. This can cause the layers to rub together, resulting in pain and discomfort. Infection An infection is the most common cause of pleurisy.Any type of infection has the potential to spread to the pleura, but viral infections are usually responsible. Viruses known tocausepleurisy include: the influenza (flu) virus the Epstein-Barr virus  whichcauses glandular fever cytomegalovirus (CMV)  a common virus found in most people, which doesnt usually cause any noticeable symptoms parainfluenza  the virus that causes the childhood condition croup In some cases, pleurisy is caused by bacteria, such as: streptococcal bacteria  often associated with pneumonia , throat infections and some types of skin infections, such as impetigo and cellulitis staphylococcal bacteria  often associated with skin infections, food poisoning and, more seriously, blood poisoning (sepsis) Meticillin-resistant Staphylococcus aureus (MRSA) can cause pleurisy, especially inhospital patients. MRSA is a type of bacteriawith a resistance to a number of commonly used antibiotics. Other causes Other possible causes of pleurisy include: injury  if the ribs are bruised or fractured, the pleura can become inflamed pulmonary embolism  a blood clot developing inside the lungs sickle cell anaemia  a blood disorder that usually affectspeople of African or Caribbean descent chemotherapy and radiotherapy HIV or AIDS lung cancer mesothelioma  a type of cancer caused by inhaling asbestos Autoimmune conditions, such as rheumatoid arthritis and lupus , are other possible causes of pleurisy. In these conditions, something goes wrong with the immune system (the bodys natural defence against infection and illness)and it begins to attack healthy tissue. Treating pleurisy Treatment for pleurisy usually involves relieving pain and treating the underlying cause of the condition. If treated promptly, pleurisyoften resolves without any lasting damage to the lungs. Treating pain The chest pain associated with pleurisy can be treated usinga type of painkiller known as non-steroidal anti-inflammatory drugs (NSAIDs) . Most often, ibuprofen is used. If NSAIDs are ineffective or unsuitable, you may be prescribed another painkiller, such as paracetamol or codeine. It may seem strange, but lying down on the side of your chest that hurts may also helpto reduce the pain. Treating the underlying cause It may also be necessary to treat the underlying cause of your pleurisy. If you have pleurisycaused by a bacterial infection, youll need a course of antibiotics . Depending on the severity of your symptoms, this may be eithertablets or injections. Combinations of different antibiotics are sometimes used. However, ifyour pleurisy is caused by a viral infection, further treatment may not be required,as the infection usually resolves itself after a few days. In cases where your symptoms are particularly severe or youre already in poor health, you may need to be admitted to hospital soyour bodys functions can be supported until your condition stabilises. Pleural effusion In some cases, pleurisy causes a build-up of excess fluid around the lungs called pleural effusion. Pleural effusion canresult inshortness of breath that gets progressively worse. Thisis more likely in cases of pleurisy caused by pulmonary embolism or a bacterial infection. If pleural effusion doesnt clear up as your pleurisy is treated, or if youre very short of breath, a tube will need to be inserted so the fluidcan be drained away. The tubemaybe inserted usingeither general anaesthetic (where youre asleep) or local anaesthetic (the area where the tube is inserted is numbed). If a lot of fluid has to be drained away,you may need to stay in hospital for a few days. Source: NHS 24 - Opens in new browser window Last updated: 02 February 2023 How can we improve this page? 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