About pleurisy (pleuritis)

What is pleurisy (pleuritis)?

Pleurisy (pleuritis) is a health condition that occurs when the pleura, the thin layer of tissue that covers the lungs, becomes inflamed. Pleurisy (pleuritis) can be caused by a variety of things, including viruses, bacteria, and even lung cancer. 

  • When the pleurae (membrane lining the thoracic cavity and the lungs) are swollen or inflamed, they may rub against each other, resulting in severe chest pain.
  • Each time your lungs expand, the enlarged and irritated pleurae push against each other, causing excruciating pain. You'll probably feel a sharp, stabbing pain in the affected area when you inhale deeply, cough, sneeze, or laugh.
  • Pleurisy (pleuritis) is snugly tucked away in your chest, lined with a thin layer of pleura.
  • When you breathe in, these layers shield your naked lungs from scraping against the wall of your chest cavity. To keep everything moving properly, there's a little fluid in the tiny area between the two layers of pleura.
  • Pleurisy (pleuritis) can be caused by infections or autoimmune illnesses in persons who have specific underlying medical conditions. 
  • Pleurisy (pleuritis) can affect persons of any age, but it is most common in people over 65. Chest infections are more common in these people.



What are the symptoms for pleurisy (pleuritis)?

Severe symptoms of Pleurisy (pleuritis) might include:

  • Chest pain: In Pleurisy (pleuritis), tissues swell up and get inflamed. The rubbing off, the pleural membrane against each other, causes pain as you inhale and exhale. Breathing, sneezing, or Coughing worsens the chest pain. 
  • Shoulder or back pain: Sometimes, the pain may radiate and spread to the shoulder or back, worsening the upper body movements.
  • Shortness of breath: In Pleurisy (pleuritis), you may experience or likely notice Shortness of breath when you try to minimize breathing. There is also a sharp, stabbing Pain in the chest resulting in a short, shallow breath.
  • Atelectasis: In case the pleural space has a large amount of fluid, it can create pressure. It compresses the lungs partially or may completely collapse. 
  • Empyema: Accumulation of pus, due to the extra fluid causing a bacterial infection. People may experience a rise in body temperature (fever).
  • Pleural effusion: This condition is also referred to as “water in the lungs”. The small space between the two layers of pleura is filled with fluid. It is known as pleural effusion. If there is an adequate amount of fluid, it will lessen the pleuritic pain, or the pain may disappear.



What are the causes for pleurisy (pleuritis)?

Doctors are not aware of the causes of pleurisy (pleuritis). The disorder usually is caused by infections. The infections can be viral, or bacterial. 

A few cases include:

  • Infections caused by bacteria such as pneumonia can lead to pleurisy (pleuritis). 
  • Viruses such as influenza, or flu can cause it.
  • The fungus can also cause pleurisy (pleuritis).
  • Hemothorax (collection of blood in the space between the chest wall and lung) can lead to pleurisy (pleuritis). 
  • Lungs and the lining inside the chest are surrounded by pleura that have a small amount of fluid that helps the lungs move in the chest and allow breathing. But fluid builds up because of cancer and other conditions. This can be serious and life-threatening.
  • Injury to the chest, heart surgery, lung or pleural cancer can also cause pleurisy (pleuritis).
  • Pulmonary Embolism (PE) is a blood clot in your lung that suddenly develops a blockage in a lung artery. 
  • Various autoimmune diseases, such as systemic lupus erythematosus (SLE or lupus) and rheumatoid arthritis, can cause pleurisy (pleuritis). 
  • Pronestyl (procainamide) and Apresoline (hydralazine) are certain drugs that may cause a lupus-like reaction that leads to pleurisy. Reactions to medicines including hydralazine (treats high blood pressure), isoniazid (treats tuberculosis), and procainamide (treats abnormal heart rhythms)



What are the treatments for pleurisy (pleuritis)?

Pleurisy (pleuritis) can be treated with certain medications and treatments. They include:

  • The pleural space can be drained for treating pleurisy (pleuritis). The removal of air, blood, or fluid from the pleural space, depends on what amount of substance is required to be drained. Needles and thoracentesis (syringes) can be used by doctors. The suction of fluid out of the area can also be done by a chest tube.
  • Using medicines such as an antibiotic, an antifungal or an anti-parasitic are recommended by the doctors to cure an infection. Ibuprofen (Advil, Motrin IB, others), a nonsteroidal anti-inflammatory drug (NSAIDs), can be helpful in relieving the pain caused by pleurisy (pleuritis). To reduce inflammation, corticosteroids can be used. This drug may cause many side effects. Bronchodilators for easy breathing may be prescribed. 
  • Painkillers and steroids can be helpful as you’re getting better.
  • Medicine codeine may be recommended by your doctor to reduce coughing, if you feel too much pain while coughing.
  • Chemotherapy or radiation treatment are used. To shrink the size of tumors, caused due to pleurisy, doctors may use cancer treatments like chemotherapy and radiation.
  • Lifestyle changes and home remedies can cure pleurisy.



What are the risk factors for pleurisy (pleuritis)?

There are many risk factors associated with pleurisy (pleuritis). The most common are weak lungs associated with breathing problems.

  • Having a lung disorder
  • A chest injury
  • Chronic liver and kidney problems
  • Sickle cell disease
  • Due to a hereditary condition called familial Mediterranean fever.
  • Surrounded by asbestos (naturally occurring fibrous minerals resistant to heat and corrosion). 
  • Systemic lupus erythematosus (SLE) is an autoimmune disease. Mistakenly, the healthy tissues are attacked by the immune system. The skin, joints, kidneys, brain, and other organs are also affected.
  • asthma, copd, and cancers of the respiratory system such as lung cancer 
  • A drug reaction- Certain medicines, including hydralazine, isoniazid, and procainamide, can cause a reaction.
  • Congestive heart failure is a condition in which there is ineffective pumping of blood by the circulatory system. This is because the heart muscles are getting enlarged and weak. It may cause pleural effusion.
  • Cirrhosis is a liver disease commonly caused by the collection of the fluid in the abdomen (ascites). It is caused when there is long-term liver damage. It doesn’t allow the proper functioning of the liver. It compromises the immunity, profoundly, making patients easy targets for pneumonia. There has been a dramatically increased mortality in cirrhotic patients with pneumonia.



Is there a cure/medications for pleurisy (pleuritis)?

The best home treatment for pleurisy (pleuritis) is to relax and wait for the underlying problem to heal. However, there are a few things that folks may do to make the wait less painful and uncomfortable.

  • Breathe deeply: To avoid pain, patients with pleurisy (pleuritis) take brief breaths. It's critical to take deep breaths on a regular basis to keep the lower lung from collapsing, a condition known as atelectasis. 
  • Quit smoking: Even in the best of circumstances, smoking is a horrible idea. It's time to quit smoking if you're having trouble breathing or have lung problems. Smokers in the house should take their cigarettes outside till they feel better.
  • Get rest: It's your job to select the most comfortable breathing position and stick to it. But don't go overboard. It's important to remember that moving around aids in the removal of fluid from the pleural cavity.
  • Medications: Over-the-counter Non-Steroid Anti-inflammatory Drugs (NSAIDs) can help ease the discomfort and swelling of pleurisy, but different people will react differently to these pain medicines. The medication that provides the most symptom alleviation with the fewest side effects is the one to use.

  • The other drugs for medication of pleurisy (pleuritis) include Aspirin, Motrin, Celebrex, Prednisone, and others.



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