Pleurisy

PLEURISY lungs

Last Updated December 20th, 2021

Overview

Pleurisy is a fairly common condition in which the pleural membranes surrounding the lungs and lining the chest cavity become inflamed and swollen. This not only produces a stabbing pain in the chest, it can also interfere with normal breathing. Depending on the underlying cause responsible for this condition, treatment approaches and prognosis can vary. The outlook is generally good but in the absence of treatment, there can be severe complications.

 

What Is Pleurisy?

pleurisy infectionPleurisy or pleuritis is the inflammation of the pleural membranes.

The visceral pleura wraps around the lungs and the parietal pleura lines the inside of the chest.

A small quantity of lubricating fluid present in the space between these two membranes helps to minimize friction from expansion and contraction of the lungs during breathing.

When these membranes become inflamed, the pressure and friction from normal inflation and deflation of the lungs produce a sharp pain in the chest. Infection may or may not be present.

 

Why Does It Happen?

Normally, the two pleural membranes rub smoothly against one another with every inhalation and exhalation. This is facilitated by a lubricating fluid present in the space between the two membranes. When the pleural membranes become irritated and swollen, they rub against each other painfully as the lungs expand and contract. Under normal circumstances, the pressure in the gap between the two pleurae remains low in order to facilitate normal inhalation and exhalation. When there is a perforation in lung tissue, this pressure gradient creates a suction force that draws in fluid or even air from the lungs into the space between the pleurae.

The causes of pleurisy range from physical trauma to infection to an underlying chronic medical disorder. These are:

  • Viral or bacterial infection as in the case of tuberculosis, influenza or pneumonia.
  • Bronchitis.
  • A chronic inflammatory illness such as systemic lupus erythematosus or rheumatoid arthritis.
  • Cancer of the lungs or breasts.
  • Tumors in the pleural membranes.
  • Pulmonary embolism or clots in the blood vessels of the lungs.
  • Sickle cell anemia.
  • Liver cirrhosis.
  • Heart failure.
  • Kidney disorders.
  • Pancreatitis or inflammation of the pancreas.
  • Exposure to substances such as asbestos and ammonia through inhalation.
  • Trauma to the chest region. For example fracture of the ribs or trauma from surgical procedures.
  • Leakage of air into the space between the pleurae from a hole in the lung.
  • Taking chemotherapy or radiation therapy.
  • Side effects of certain medications.

 

What Are The Signs of Pleurisy?

pleurisy lung infectionThe exact nature of symptoms associated with pleurisy depends on the cause of the condition. Since the pleurae contain nerve endings, pleuritis produces a sharp or stabbing pain. Coughing or even normal inhalation tends to aggravate this pain. If the cause of pleurisy is an infection, then the typical symptoms of infection such as fever will also be observed. Symptoms of pleurisy include:

  • Sharp pain in the chest, usually on one side. This pain worsens with breathing or coughing. It can manifest either in the front or the back.
  • Tenderness in the chest area.
  • Pain can spread to the shoulder, neck or the abdomen.
  • Shallow breathing.
  • Shortness of breath, often as a result of pleural effusion or fluid buildup between the pleural membranes.
  • A dry cough.

 

What Are Two Types of Pleurisy?

Depending on whether or not pleural effusion is involved, pleurisy may be categorized as either wet or dry.

  • Dry pleurisy: The volume of the pleural fluid remains normal and symptoms such as chest pain are explained by the rubbing together of the inflamed pleural membranes with inhalation.
  • Wet pleurisy: Here, pleuritis is accompanied by an excess buildup of fluid between the pleural membranes. This has the effect of reducing the pain but this abnormal quantity of fluid puts pressure on the lungs and reduces their ability to expand fully. As a result of this, the patient feels short of breath.

 

Complications Related To Pleurisy

Pleural effusion or excess buildup of fluid between the pleurae is one of the most common complications of pleurisy. In case of an infectious disease such as pneumonia, there is the risk of developing empyema. This occurs when the fluid between the pleurae becomes infected with bacteria and thickens because of the formation of pus. This causes difficulty in breathing and the pus needs to be drained out to offer relief. Another possible critical outcome is a collapse of the lungs.

Permanent scarring resulting in the formation of adhesions is also possible. This can lead to permanent impairment of respiratory function.

 

Diagnosing Pleurisy

PLEURISY lungsA physical examination reveals some local tenderness.  Using a stethoscope, the physician listens to the sounds of breathing. A scratchy rubbing sound observed during breathing points to dry pleurisy. The patient’s medical history might indicate a disorder that could be the underlying cause for the pleuritis.

In instances of wet pleurisy, the patient will also exhibit shallow breathing. Chest X-ray helps to ascertain whether or not pleural effusion is involved. If it is, a small sample of the fluid will be aspirated out to test whether an infection is present. Blood tests help identify the cause of the infection and detect autoimmune disease if any is present.

Further imaging tests would be required in order to assess the extent of effusion. It may also be required if the physician suspects that pleurisy is a result of a disorder of other organs such as the liver or pancreas. Tests such as computerized tomography (CT) or magnetic resonance imaging (MRI) can reveal any other abnormalities such as tumors, lung abscesses or pulmonary embolism that could be responsible for pleurisy.

 

Treatment and prevention

Antibiotics are prescribed for pleurisy which is caused due to bacteria. When an infection is a cause it generally does not require any treatment as it resolves itself.  Chest pains associated with pleurisy are relieved by non-steroidal anti-inflammatory drugs such as ibuprofen. It is rather difficult to prevent pleurisy as it is infection or bacteria that were still present in your system after a recent case of tuberculosis or pneumonia for instance. Though, an early diagnosis can help in the reduction of the treatment process.

Facts

  • Pleurisy is caused by the inflammation of the lining of the lungs and chest cavity.
  • It can be caused by infections such as tuberculosis, immune disorders such as systematic lupus erythematosus ( SLE), rheumatoid arthritis etc.

Facts

  • Symptoms include – chest pain, aggravated breathing, shortness in breathing, local tenderness etc.
  • A large amount of fluid build-up in the lungs lining is known as pleural effusion.

Facts

  • There is a characteristic noise generated when the two membranes rub against each other in pleurisy, which is known as “friction rub”.

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Dos and Don'ts

Dos
  • If any of the symptoms are severe make sure to get an appointment with your doctor.
  • Get a chest imaging done – X-ray, CT scan etc.
  • A bronchoscopy (putting a thin tube via the airway) would be done to check the level of severity.
Don'ts
  • Smoking; as it could make the conditions of your lungs worse and make breathing difficult.
  • Avoid an early treatment for any infection as once it settles in your lungs it could lead to pleurisy.
  • Expose yourself to harsh chemicals such as ammonia.

 

 

 

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Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
CBC blood test
CBC (Hemogram 6-part diff) blood test CBC (Hemogram 6-part diff) blood test refers to the test that measures the number of RBCs, WBCs, etc…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Bone marrow aspiration Bone marrow aspiration is a process where a sample of the bone marrow is withdrawn from the bone…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Sushi: health benefits and recipes Sushi is a traditional Japanese dish prepared with vinegared rice served with fish (often raw), vegetables, and other…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…