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Pleurisy is the swelling (inflammation) of the thin tissue layer (pleura) which covers the lungs and the rib cage. The outer layer of pleura covers the rib cage and the internal layer covers the lungs. The narrow space found between the two pleural layers contains a small amount of liquid that is involved in lubrication, allowing the two layers to slide one on the other during breathing. When the pleura becomes inflamed, the two layers rub one against the other, causing chest pain. This is called pleural pain. Pleurisy is sometimes called pleuritis.
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In young people with a strong health, a viral infection that occurs in the lower respiratory tract or a pneumonia can also cause the inflammation of the pleura resulting in pleurisy. Pleurisy caused by a viral infection lasts a few days to 1-2 weeks. In very rare cases, pleurisy can spread to other people as well, that is, is contagious. Pleurisy may occur in other situations as well, such as the air leakage into the pleural cavity (pneumothorax), chest injuries (a broken rib), tuberculosis or other infections or pleural tumor. There area also other conditions that can cause pleurisy. These are rheumatoid arthritis, lupus, sickle-cell anaemia, pulmonary embolism, or pancreatitis. Pleurisy can also occur as a complication of heart surgery.


Symptoms that occur in pleurisy are chest pain and difficult breathing (dyspnea). The chest pain usually has a sudden onset. Most often it is described by patients as a stinging pain. The caracheristics of pain are:
- It is continuously present but may get worse when breathing, during inspiration. Patients avoid breathing deeply in order to prevent pain.
- It usually occurs on only one side of the chest (unilateral)
- It may spread to the shoulder or abdomen
- It usually worsens when you cough, sneeze or make sudden movements
- It can relieve when breathing is stopped intentionally or a compression is put on the chest, on the painful area.
If pleurisy is caused by a viral infection, you may or may not have common viral symptoms such as fever, headache, and muscle aches. The inflammation of pleura can sometimes cause the accumulation of fluid in the pleural cavity (pleural effusion). You may have less pain after the occurence of this process, because the accumulation of fluid prevents the layers of the pleura rubbing one against the other. If there is a large amount of accumulated fluid in the pleural cavity, lung expansion can be reduced during inspiration, causing shortness of breath. Other symptoms of pleural effusion include fever, chest pain and cough. The pleural effusion can occur in other conditions than in those associated with pleurysis as well, such as heart failure or liver or kidney disorders.


Since many types of doctors can meet with pleurisy, they will try to find the cause which produced it. It is necessary a physical examination, a chest radiograph in order to see which are the signs that led to chest pain, namely:
- Viral infection
- Contraction of chest muscles
- Fracture of a rib
- Presence of a thrombus in the intrapulmonary vessels (pulmonary embolism)
- Inflammation of the heart wall (pericarditis)
- Pneumonia
- Tuberculosis
- The presence of fluid in the pleural cavity (pleural effusion).
If your doctor has suspected the presence of an autoimmune disease, such as lupus or rheumatoid arthritis, further investigation is required.
If pleural effusion is present, fluid from the pleural cavity can be removed by using a needle (thoracentesis), and this can be sent to the laboratory for analysis and the identification of the cause of the disease.


The treatment of pleurisy depends on the cause which produced it. For example, if the cause is a bacterial infection, it requires antibiotic treatment. If a pulmonary embolism is also present, treatment to slow or prevent clotting (anticoagulants) is required. In most cases of pleural pain caused by pleurysis, medicines such as aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) can be given. If a severe pain is present, a treatment for cough or pain is necessary. The pain can be relieved when lying on the painful side or by compressing it with a pillow.
In the case of pleural effusion, it is necessary to remove the fluid from the pleural cavity by using a tube which is inserted through the rib cage. In some cases of pleural effusion, pleurodesis may be tried. This therapeutic procedure consists of the injection of a chemical substance or a drug in the chest, which will produce a local inflammation in the lung surface and inside the rib cage. This produces the adhesion of the lungs with the chest cavity, thereby preventing the formation of fluid in the pleural cavity.




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