Pleurisy is inflammation of the pleura, the membranes that surround the lungs, and the inside of the chest cavity. Pleurisy is often referred to as pleuritis or inflammation of the pleura. There is a small space between the lungs and the chest cavity wall, called the pleural space, which is normally filled with fluid (pleural fluid). The fluid ensures that the membranes move smoothly against each other when a person breathes in and out. Because the pain sensation fibers of the lungs are located in the pleura, inflammation of these tissues caused by pleurisy results in a sharp, distinctive pain in the chest.
When there is inflammation in the chest or lungs, the pleura may rub directly against each other. This typically causes a sharp pain on the inflamed side of the chest that occurs when a person breathes in. Pleurisy is often associated with excess fluid in the pleural space, called pleural effusion. This puts pressure on the pleural space, which can also cause pain when a person breathes in. There is generally no pain between breaths. Coughing and shortness of breath can occur as well.
Pleurisy is most often caused by viral infections. Some medications and medical conditions, such as lupus and tuberculosis, may also cause pleurisy.
Pleurisy can happen to any person at any age. It is more likely to occur in patients with a medical condition known to cause pleurisy or in patients with recurrent lung infections. The duration of pleurisy depends on the cause. If it is caused by a viral infection, it will usually go away within a few days. If a bacterial infection causes pleurisy, it will last until the infection is cleared with antibiotics. Patients with pleurisy caused by lung cancer or other diseases can have symptoms that last much longer.
Pleurisy is treated by addressing the underlying cause, which is usually determined by diagnostic tests. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first line of treatment for the pain and inflammation. Narcotics may be given if NSAIDs do not improve the pain. Fluid may also be physically removed from the lungs.
If pleurisy goes untreated, it may lead to a pleural effusion, which is accumulation of fluid in the pleural space. If pleural effusion goes untreated, the pressure on the lungs can lead to respiratory distress or possible lung collapse.
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