Pleurisy

Pleurisy is a sharp chest pain that happens when the lining of the inside of your chest wall (pleura) gets inflamed. Pleurisy (pronounced “PLUR-uh-see”) is also called pleuritis.

Your lungs and the inside of your chest are each lined with a thin layer called pleura. Fluid fills the space between them. This allows them to slide smoothly along each other when you breathe in and out, like oil in a machine. When your chest wall pleura is inflamed, it can hurt when your chest moves as you breathe.

Symptoms of pleurisy

The main symptom of pleurisy is chest pain (pleuritic pain). The pain:

• Feels sharp or stabbing
• Happens in one specific place in your chest
• Is worse when you breathe deeply or cough
• Sometimes spreads to your shoulder or back
• Can cause you to breathe and swallow carefully to avoid the pain

You might also have:

• Shortness of breath
• Cough
• Fever
• Extreme tiredness

Pleurisy causes

Most often, a virus (like the flu), bacteria or other infection in your lungs causes pleurisy. Infections can cause inflammation in your pleura. This can cause chest pain as your lungs expand when you breathe in.

You can also get pleurisy from:

• Autoimmune diseases, like lupus, rheumatoid arthritis or inflammatory bowel disease
• Lung or pleural disease, like pneumonia, lung cancer, mesothelioma or asbestosis
• Chest surgery or trauma
• Rib fractures
• A blood clot in your lung (pulmonary embolism)
• Sickle cell disease
• Certain medications, including hydralazine, isoniazid and procainamide

Risk factors

Anyone can get pleurisy, but you’re at a higher risk if you:

• Are over 65
• Have a condition that causes inflammation in your body (like an autoimmune disease)
• Take medications that cause inflammation in your body
• Have tumors or scarring in your lungs

Complications

Complications of pleurisy include:

• Partial lung collapse (atelectasis)
• Excess fluid around your lungs (pleural effusion)
• Pus collecting around your lungs (empyema)
• Infection (pneumonia)

How doctors diagnose pleurisy

To diagnose pleurisy, your healthcare provider will listen to your lungs and ask about your health history. They’ll ask you questions about your pain, like where it hurts, what it feels like and if anything makes it worse.

They may want you to get imaging or other tests done. These could include:

• Blood tests, to look for signs of infection or autoimmune disorders
• Electrocardiogram (EKG or ECG), to rule out heart conditions
• Imaging tests, like chest X-rays or CT scans, to look for lung or heart issues
• Fluid testing (using thoracentesis), to look for infections or other causes
• Thoracoscopy, to look inside your lungs

How is pleurisy treated?

Treatment for pleurisy depends on what’s causing it. Your healthcare provider will work with you to treat the underlying cause. They can also help you manage your pain in the meantime.

Treatment options might include:

• Medication to treat infections, like antibiotics or antifungals
• Pain relievers, like ibuprofen, naproxen, acetaminophen or corticosteroids
• Fluid draining (thoracentesis) to help with pain

When should I see my healthcare provider?

If you’re having unexplained chest pain, call 911 or go to the emergency room. Some causes of chest pain need to be treated immediately.

What can I expect if I have pleurisy?

The outlook depends on what’s causing it. If an infection is causing it, it should go away as you get better. If an ongoing illness, like cancer or an autoimmune disease, is causing it, you may always have some risk of pleurisy coming back.