Pleurisy (ploor-ih-see) is a condition in which the pleura (two large, thin layers of tissue that separate the lungs from the chest wall) become inflamed. Also called pleurisy, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing.
A pleural layer of tissue surrounds the outside of the lungs. the other pleural layer lines the inner chest wall. Between these two layers is a small space (pleural space) that is usually filled with a very small amount of fluid. These layers act like two pieces of smooth satin that slide past each other, allowing your lungs to expand and contract when you breathe.
If you have pleurisy, these tissues become swollen and inflamed. as a result, the two layers of the pleural lining rub against each other like two pieces of sandpaper. this causes pain when you breathe in and out. pleuritic pain decreases or stops when you hold your breath.
Treatment of pleurisy involves pain control and treatment of the cause.
Signs and symptoms of pleurisy may include:
- chest pain that worsens when breathing, coughing, or sneezing
- difficulty breathing, often from trying to limit inhalation and exhalation
- cough, only in some cases
- fever, only in some cases
- pleural effusion. In some cases of pleurisy, fluid collects in the small space between the two layers of tissue. this is called a pleural effusion. When there is a good amount of fluid, pleuritic pain decreases or disappears because the two layers of the pleura are no longer in contact and do not rub against each other.
- Atelectasis. A large amount of fluid in the pleural space can create pressure. this can compress your lung to the point of partial or complete collapse (atelectasis). this makes it hard to breathe and can cause coughing.
- empyema. excess fluid in the pleural space can also become infected and cause a collection of pus. this is called an empyema. the fever often occurs together with an empyema.
- viral infection, such as influenza (flu)
- bacterial infection, such as pneumonia
- fungal infection
- autoimmune disorder, such as rheumatoid arthritis or lupus
- lung cancer near the pleural surface
- pulmonary embolism
- tuberculosis (tb)
- rib fracture or trauma
- certain hereditary diseases, such as sickle cell disease
- certain medications and recreational drugs
Pain caused by pleurisy can worsen with movement of the upper body and may spread to the shoulders or back.
pleurisy can occur together with pleural effusion, atelectasis or empyema:
when to see a doctor
Call your healthcare provider or seek emergency care right away if you experience unexplained severe chest pain during breathing. you may have a problem with your lungs, heart, or pleura, or an underlying condition for which you need immediate medical attention.
A variety of conditions can cause pleurisy. causes include: