Pleurisy

Overview

Pleurisy, also known as pleuritis, occurs when the lining around the lungs or the inside wall of the chest becomes inflamed, causing sharp pains as the two layers rub against each other. This results in discomfort during both inhalation and exhalation. The pain diminishes or ceases when one refrain from breathing.

The lungs are surrounded by two layers of tissue called the pleura. One layer covers the outside of the lungs, while the other lines the inner chest wall. These layers work together smoothly, like satin, allowing the lungs to expand and contract when breathing. However, in pleurisy, these tissues become swollen and inflamed, causing them to rub against each other harshly, similar to sandpaper.

Common triggers of pleurisy include viral or bacterial infections, autoimmune disorders, and various lung ailments. Managing pain and addressing the underlying cause are the usual approaches in treatment.

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