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Pleurisy

Respiratory system...Respiratory system overview

Pleuritis; Pleuritic chest pain

Definition

Pleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.

Causes

Pleurisy may develop when you have lung inflammation due to infection, such as a viral infection, pneumonia, or tuberculosis.

It may also occur with:

Certain cancers
Chest trauma
Blood clot (pulmonary embolus)
Rheumatoid arthritis
Lupus (systemic lupus erythematosus)

Symptoms

The main symptom of pleurisy is pain in the chest. This pain often occurs when you take a deep breath in or out, or cough. Some people feel the pain in the shoulder.

Deep breathing, coughing, and chest movement make the pain worse.

Pleurisy can cause fluid to collect inside the chest. As a result, the following symptoms can occur:

Coughing
Shortness of breath
Rapid breathing
Pain with deep breaths

Exams and Tests

When you have pleurisy, the normally smooth surfaces lining the lung (the pleura) become rough. They rub together with each breath. This results in a rough, grating sound called a friction rub. Your health care provider may hear this sound with the stethoscope.

Your provider may order the following tests:

Complete blood count (CBC)
X-ray of the chest
CT scan of the chest
Ultrasound of the chest
Removal of pleural fluid with a needle (thoracentesis) for analysis

Treatment

Treatment depends on the cause of the pleurisy. Bacterial infections are treated with antibiotics. Surgery or insertion of a tube in the chest may be needed to drain infected fluid from the lungs. Viral infections normally run their course without medicines.

Taking acetaminophen or ibuprofen can help reduce pain.

Outlook (Prognosis)

Recovery depends on the cause of the pleurisy and your general health condition.

Possible Complications

Health problems that may develop from pleurisy include:

Breathing difficulty
Fluid buildup between chest wall and lung
Complications from the original illness

When to Contact a Medical Professional

Contact your provider if you have symptoms of pleurisy. If you have breathing difficulty or your skin turns blue (cyanosis), seek medical care right away.

Prevention

Early treatment of bacterial respiratory infections can prevent pleurisy.

References

Fenster BE, Lee-Chiong TL, Gebhart GF, Matthay RA. Chest pain. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 38.

McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.

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Review Date: 8/13/2023

Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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