Pleurisy

Also called pleuritis, pleurisy is an inflammation of the visceral and parietal pleurae that line the inside of the thoracic cage and envelop the lungs. The disorder causes the pleurae to become swollen and congested, hampering pleural fluid transport and increasing friction between the pleural surfaces.

Causes

Pleurisy can result from pneumonia, tuberculosis, viruses, systemic lupus erythematosus, rheumatoid arthritis, uremia, Dressler's syndrome, cancer, pulmonary infarction, and chest trauma.

Signs and Symptoms

People with pleurisy may experience:

• pain: pain during each breath, pain when you move, and extreme pain when you cough or sneeze
• shallow and difficult breathing
• dry coughing
• weakness
• headache
• loss of appetite
• chills
• fever
• rapid heartbeat

Diagnostic tests

Although diagnosis generally rests on the patient's history and your respiratory assessment, diagnostic tests help rule out other causes and pinpoint the underlying disorder. Electrocardiography rules out coronary artery disease as the source of the patient's pain, and chest X-rays can identify pneumonia.

Treatment

Symptomatic treatment includes anti-inflammatory agents, analgesics, and bed rest. Severe pain may require an intercostal nerve block of two or three intercostal nerves. Pleurisy with pleural effusion calls for thoracentesis as both a diagnostic and a therapeutic measure.

Prevention

Early treatment of bacterial respiratory infections can prevent pleurisy.