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Pleurisy And Pleural Effusion

Medically reviewed by Drugs.com. Last updated on Mar 1, 2024.

What is Pleurisy And Pleural Effusion?

Harvard Health Publishing

Pleurisy means inflammation of the pleura, the membrane that lines the lungs within the chest cavity. Depending on its cause, pleurisy can be associated with an accumulation of fluid in the space between the lungs and chest wall (called a pleural effusion) or it can be dry pleurisy, which has no fluid accumulation.  

Pleurisy can develop many ways, including: 

Symptoms

Pleurisy typically causes a sharp chest pain (pleuritic chest pain) that worsens with breathing in or coughing. The pain may start and remain in one specific area of the chest wall, or it may spread to the shoulder or back. To ease chest pain from pleurisy, a person with pleurisy often lies on the affected side as a way of limiting movement of the chest wall. In rare cases, the chest pain of pleurisy is a fairly constant, dull ache.  

Depending on the specific cause of pleurisy, other symptoms may be present. For example, a person with pneumonia may have a high fever, shortness of breath and a cough that produces thick, yellow or dark sputum (mucus). A pulmonary embolus may be associated with shortness of breath, a low-grade fever and a cough that brings up small amounts of blood. A person with lung cancer may have unexplained weight loss and cough.

Diagnosis

Your doctor will ask about your medical history, including your history of smoking. He or she also may ask whether you have been anywhere where you may have been exposed to tuberculosis.  

To confirm the diagnosis, he or she will examine you, paying special attention to your lungs. Your doctor will check for signs of pleural effusion by gently tapping your chest wall. He or she also will listen with a stethoscope to check for a pleural friction rub, the rough, scratchy sound of the inflamed layers of pleura sliding past each other during breathing. Depending on the results of your physical examination and the suspected cause of your pleurisy, the doctor then may recommend: 

Depending on the results of these preliminary tests, additional tests may be necessary to confirm the diagnosis. For example, in patients with suspected pulmonary embolism, a lung scan or CT scan of the lungs may be used to confirm the diagnosis. A patient with confirmed pleural effusion may require a procedure called thoracentesis, in which some chest fluid is removed and sent to a laboratory to be tested. 

Expected Duration

How long pleurisy lasts depends on its cause. For example, pleurisy caused by pleurodynia may come and go over a few days. In rare cases, a person with pleurodynia may have several episodes of pleuritic chest pain over several weeks before the illness finally goes away. In patients with bacterial pneumonia or rheumatic fever, pleurisy typically goes away when the infection is cured with antibiotics. In patients with lung cancer or connective tissue disease, the chest pain of pleurisy may persist for longer periods. 

Prevention

In some cases, you can prevent pleurisy by preventing the medical condition that causes it. For example, some types of pneumonia can be prevented by vaccination. The risk of lung cancer is reduced by not smoking.  

Not all cases of pleurisy can be prevented. 

Treatment

The treatment of pleurisy depends on its underlying cause: 

When To Call A Professional

Call your doctor immediately or go to an emergency room if you experience any form of severe or persistent chest pain or any difficulty breathing. Chest pain can be a symptom of many different disorders, some of which are potentially life threatening.

Prognosis

In patients with pleurisy, the outlook depends on the underlying medical illness. 

Additional Info

American Lung Association
https://www.lung.org

National Heart, Lung, and Blood Institute (NHLBI)
https://www.nhlbi.nih.gov/


Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.