Pleurisy: Causes, Symptoms, Risk Factors, Diagnosis and Treatment

Pleurisy is a disease caused by inflammation of the pleura, which are the two big, thin layers of tissue that separate your lungs from your chest wall. The classic sign of pleurisy, or pleuritis, is acute chest pain, commonly called pleuritic pain, that gets worse as you breathe.

The outer surface of the lungs is covered in a single pleural layer of tissue. The other pleural layer lines the chest's interior wall. The pleural gap, a little opening between these two layers, is often only partially filled with fluids. 

Your lungs may expand and contract when breathing due to these layers, which resemble two pieces of silky satin slipping past each other.

When you have pleurisy, these tissues grow and become inflamed. As a result, the two layers of the pleural lining rub against one another like sandpaper. Inhaling and exhaling through this hurts. The pleuritic pain is lessened or quits when you hold your breath.

Pleurisy treatment consists of treating the underlying cause and controlling pain.

Causes Of Pleurisy

Pleasure can result from various medical conditions. Among the reasons are:

• Viral illness, such as the flu
• Pneumonia 
• Fungal illness
• Autoimmune disorders, such as rheumatoid arthritis or lupus
• Lung cancer that is near the pleural layer
• Pulmonary embolism
• Tuberculosis
• Damage or rib fractures
• Certain drugs on prescription and drugs used recreationally

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Symptoms Of Pleurisy

Among the warning symptoms and indicators of pleurisy are:

• Chest pain that intensifies when inhaled, exhaled, or coughed.
• Shortness of breath, usually caused by trying to limit breathing in and out.
• Cough, but only on occasion.
• Fever, in specific cases only.
• Back or shoulder pain may be radiated by pleurisy-related pain that gets worse when you move your upper body.

Emphasis, atelectasis, or pleural effusion may coexist with pleurisy:

• A pleural effusion: Under specific pleurisy circumstances, there may be a build-up of fluid in the narrow space between the two tissue layers. We call this effusion of the pleura. When a reasonable amount of fluid is present, pleuritic pain reduces or disappears because the two layers of pleura are no longer in contact and do not rub against one another.
• Atelectasis: Numerous fluids in the pleural space can create pressure. This may cause your lung to collapse completely or partially (atelectasis). Coughing and breathing difficulties could result from this.
• Empyema: If contaminated excess fluid accumulates in the pleural area, pus may build up there. Fever frequently happens along with an empyema.

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Risk Factors Of Pleurisy

Pneumonia and the flu are two common diseases that increase your risk of pleurisy. Additionally, some illnesses including lupus, TB, and sickle cell disease can increase your risk. Pleurisy risk is also increased by the use of some drugs for recreational purposes or prescriptions.

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Diagnosis Of Pleurisy

Usually, your doctor will start by going over your medical history and doing a physical examination, which could include listening to your chest with a stethoscope.

To identify the cause of pleurisy and make a diagnosis, your doctor might recommend:

• Blood tests: A blood test could be able to identify an infection if one exists. More blood testing could reveal the presence of an autoimmune condition like lupus or rheumatoid arthritis. In some cases, the first sign could be pleurisy.
• Chest X-ray: An X-ray of your chest can show if your lungs are fully expanded or whether there is fluid or air between your lungs and ribs.
• Computerized tomography, or CT scan: A CT scan is a collection of several X-ray pictures of your body collected from different perspectives. Through computer processing, it produces cross-sectional images that look like slices of your chest. These incredibly detailed pictures show the condition of the pleura. They can also show whether there are any other reasons for discomfort, such as a lung blood clot.
• Ultrasound: This imaging technique produces precise images of your body's internal structure using high-frequency sound waves. You may undergo an ultrasonography to determine whether you have a pleural effusion.
• Cardiogram is sometimes referred to as an ECG or EKG: This cardiac-monitoring test might be recommended if certain cardiac problems are determined to cause your chest pain.

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Methods For Making Diagnoses

Occasionally, your healthcare provider may remove tissue and fluid from the pleural space for analysis. Procedures could include:

• Thoracentesis: During this procedure, a local anesthetic (numbing drug) is injected between your ribs to the spot where your imaging tests revealed fluid. After that, a needle is inserted between your ribs and into your chest wall to remove fluid for laboratory analysis. Giving up liquids will also help you breathe better. Usually, ultrasound guidance is utilized to assist in needle implantation.
• Thoracoscopy: A pleuroscopy, sometimes referred to as a thoracoscopy, may be performed if cancer or tuberculosis are suspected. During this surgery, a tiny incision in your chest wall is made to insert a tiny camera called a thoracoscope. With this procedure, a direct view into your chest can be acquired to look for any problems or to take a tissue biopsy sample.

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Treatment Of Pleurisy

Treating the underlying cause of pleurisy is the main objective of treatment. For example, if the cause is bacterial pneumonia, an antibiotic would be suggested to treat the illness. In cases where a viral infection is the underlying cause, pleurisy may resolve on its own.

Advil, Motrin IB, and other nonsteroidal anti-inflammatory drugs (NSAIDs) contain ibuprofen, which is commonly used to treat pleurisy-related pain and inflammation. Occasionally, a medical practitioner may advise using steroids.

The degree of response to treatment for people with pleurisy depends on the underlying reason. If the underlying cause of your pleurisy is found and addressed, your recovery time will be accelerated. Depending on the condition and the cause, you may fully recover.

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