Pleurisy

Overview

Pleurisy, or pleuritis, arises when the pleura—two thin, protective layers of tissue enveloping the lungs and lining the chest cavity—become inflamed, leading to sharp, stabbing pains in the chest known as pleuritic pain. This discomfort escalates with breathing, coughing, or sneezing, as these actions cause the inflamed pleural layers to rub against one another. Normally, these layers are lubricated by a small amount of fluid in the pleural space, allowing for smooth, frictionless movement during respiration. However, inflammation disrupts this smooth interaction, making each breath painfully reminiscent of coarse surfaces grating together.

Treatment for pleurisy is twofold, aiming to both alleviate the immediate discomfort caused by the condition and address its root cause to prevent ongoing irritation. This usually involves managing the pain through medication and tackling the underlying condition, such as an infection or other disease, that led to the pleural inflammation. By controlling the inflammation and ensuring the pleura can move smoothly once more, patients can find relief from the acute pains of pleurisy and return to normal breathing patterns.

Pleurisy may also develop along with other conditions, such as:

• Pleural effusion: This happens when fluid accumulates in the space between the layers of tissue, alleviating pleuritic pain by separating the layers and preventing rubbing.
• Atelectasis: Breathing difficulties and coughing may occur when significant fluid buildup in the pleural space exerts pressure, potentially leading to partial or complete collapse of the lung.
• Empyema:  The formation of pus known as empyema, accompanied by fever, may develop when excess fluid in the pleural space becomes infected.

Symptoms

The primary indication of pleurisy is chest pain, known as pleuritic pain, characterized by a sharp, stabbing, or knife-like sensation originating from a particular location. This discomfort intensifies with upper body movements, deep breathing, or coughing and may occasionally radiate to the shoulder or back.

Other symptoms include:

• Shortness of breath
• Fatigue
• Fever
• Cough

It’s important to emphasize that certain causes of chest pain can entail serious risks. If you experience chest pain, it’s imperative to promptly seek medical attention at the nearest emergency room. Chest discomfort could potentially signify problems with the lungs, heart, or pleura, or it might indicate an underlying illness necessitating urgent medical intervention.

Causes

The most common causes of pleurisy are viral infections, bacterial infections, or other lung infections. These infections can lead to inflammation in the pleurae, resulting in chest pain.

Other potential causes include:

• Autoimmune conditions, such as lupus, rheumatoid arthritis, or familial Mediterranean fever (FMF)
• Lung or pleural illnesses such as lung cancer, mesothelioma, tuberculosis, or asbestosis
• Fungal infection
• Pulmonary embolism
• Trauma, chest surgery, or fractured ribs
• Recreational drugs and certain medications, including hydralazine, isoniazid, and procainamide
• Some hereditary illnesses, like sickle cell disease
• Inflammatory bowel disease

Risk factors

Pleurisy can affect anyone. However, certain factors may increase one’s risk of developing one, such as:

• Age: Being older than 65
• Infections: Having flu and pneumonia
• Certain medical conditions: This include autoimmune disorders, lupus, TB, and sickle cell disease
• Medications: Medications that causes inflammation in the body