What Is Pleurisy? What Causes Pleurisy?

Pleurisy, also known as pleuritis, is a condition that results from the swelling of the linings of the lungs and chest. The pleural cavity (area between lungs and inner chest wall) is created by two lubricated surfaces called pleura, the inner pleura lining the lungs and the outer lining the chest wall.

A variety of factors can cause the pleura to become inflamed and rub against one another, rather than slide smoothly, as one breathes. This is the cause of the chest pain associated with pleurisy (often called pleuritic pain).

Pleurisy used to be common complication of bacterial infections a long time ago; especially of pneumonia. Since the advent of antibiotics, however, rates have dropped substantially.

It is hard to estimate how many people get pleurisy worldwide because it is often a mild condition that resolves itself without any treatment; without the doctor being told.

Some famous people have had pleurisy, including Hernan Cortes (died of it), Catherine de Medici (died of it), Benjamin Franklin (died of it), Mahatma Gandhi, Elvis Presley (had recurring pleurisy), and Ringo Starr (at age 13), William Wordsworth (died of it), and Judy Garland.

What causes pleurisy?

Pleurisy is a common complication of several different medical conditions, the most pervasive being a viral infection of the lower respiratory system.

Other causes include:

• Bacterial infections such as pneumonia and tuberculosis
• A chest wound that punctured the pleural cavity
• A pleural tumor
• Autoimmune disorders like lupus and rheumatoid arthritis
• Sickle cell anemia
• Pancreatitis
• Pulmonary embolism
• A heart surgery complication
• Lung cancer or lymphoma
• A fungal or parasitic infection
• Familial Mediterranean fever
• Infections can sometimes spread from person to person, but it is rare to "catch" pleurisy.

Who is at risk of getting pleurisy?

Due to pleurisy being the result of one or more of many adverse conditions, anyone is at risk of contracting pleurisy. When being diagnosed with one of the myriad of conditions listed above, be aware of any symptoms you may be experiencing and their relation to pleurisy. Someone who is sickly or has had a chest injury or heart surgery has a higher chance of getting pleurisy.

What are the symptoms of pleurisy?

The main symptom of pleurisy is a sharp, stabbing pain in the chest. This pain can affect the shoulders and back as well, but is often on one side of the chest only. A person with pleurisy will sneeze, cough, and exercise shallow breathing due to the pain caused by deep breathing.

Patients often describe a constant aching pain that may vary in dullness with the cause of the inflammation. If your pleurisy is caused by a viral infection, you may also experience fever, chills, headaches, joint pain, and muscle aches. Difficulty breathing and a sore throat can also occur.

How is pleurisy diagnosed?

When diagnosing pleurisy, doctors often search for the cause of the inflammation. A patient may have a rib injury or infection of which he is not fully aware. Simple physical exams and chest x-rays will most likely be ordered. A blood sample can also be taken to check for autoimmune disorders. If one has a pleural effusion, a doctor can use a needle to get a fluid sample from the pleura in a procedure called a thoracentesis.

Pleurisy can also be diagnosed by:

• CT scan
• Ultrasound
• MRI scan
• Biopsy (if cancer is suspected)
• Arterial blood gas sampling (to test lung capacity)

How is pleurisy treated?

When treating pleurisy, doctors often seek to treat the root cause, such as a virus or other infection. Antibiotics will be prescribed if your pleurisy is a result of a bacterial infection. In some pleural effusion cases, one may need to have the fluid drained out of their pleural cavity via a tube inserted into the chest. To treat pleuritic pain, doctors may recommend aspirin, ibuprofen, or NSAIDs (non-steroidal anti-inflammatory drugs). In some severe cases, prescription pain and cough medicines may be used, including codeine-based cough syrups. Those found to have pulmonary embolisms may need to take anti-bloodclotting medicine to prevent future complications.

One procedure to treat pleurisy involves the placing of fibrinolytic drugs into the chest to break up blood clots and pus, which is then drained through a tube. If the fluids still do not drain, a surgical procedure can be undertaken. Native Americans utilized the Pleurisy root or butterfly weed to treat pleurisy due to its mucous thinning properties. This method is less effective, and may not always be successful. Ultimately, one's pleurisy treatment is tied to the severity of the underlying condition.

How can pleurisy be prevented?

Pleurisy can be prevented only by the early detection and management of the causal disease. For example, an early diagnosis and treatment of an infection can prevent fluid from building up in the pleural cavity. In other cases, management of a more serious disease can reduce the amount of inflammation or fluid build-up one may experience.

Pleurisy, stemming from so many other conditions, is often difficult to diagnose or confused with other diseases. When you are being treated for any condition, it is important to get plenty of rest and maintain a healthy diet so as to avoid developing complications such as pleurisy.