Introduction
Pleura are the large, thin tissue layers that separate the lungs from the chest wall. Pleurisy is the painful condition that causes these layers to inflame. Pleural space is the gap among pleura. The fluids fill up pleural space, causing stabbing, sharp chest pain, especially when a person breathes, sneezes, or coughs. Furthermore, it has been referred to as pleuritic pain. This pain can be mild or life-threatening.
Symptoms
When pleura has been inflamed and swollen, they rub each other and cause stabbing pain in the chest. Sometimes, this pleuritic pain spreads to the back or shoulder. The pain has been stopped or lessened if a person holds his breath. These are the other symptoms and signs of pleurisy, which may include:
- Fever
- Fatigue
- Weight loss
- Cough
- Breathing difficulties
- Chills
Causes
These are the different causes of pleurisy, such as
-
- Bacterial infections: These infections have been the common causes of pleurisy. For example, pneumonia and tuberculosis may cause bacterial pleurisy.
- Viral infections have resulted in viral pleurisies, such as influenza or flu.
- Autoimmune disorders: These disorders may cause pleurisy. For example, rheumatoid arthritis or lupus.
- Fungal infections: Fungal infections have resulted in fungal pleurisies, such as aspergillus.
- Pulmonary embolism is the obstruction of blood clumps in pulmonary arteries that supply blood into the lungs. Pulmonary embolism has been a severe cause of pleuritic pain. About 5 to 21% of pleuritic patients have a pulmonary embolism.
- Lung cancer: Pleurisy is caused by lung cancer that affects the lungs.
- Asbestosis: It is a lung disease that has been caused by inhaling asbestos. Asbestos patients have inflammation in the pleura. The pleural inflammation causes breathing difficulties.
- Inflammatory bowel disease (IBD): It has been used for ulcerative colitis and Crohn’s disease that causes inflammation in the gastrointestinal tract. These diseases can rarely cause pleurisy.
- Some medications: Pleurisy has been caused due to some medicines, such as isoniazid, procainamide, and hydralazine. Among them, isoniazid has been used in treating tuberculosis, and procainamide has been used for heart arrhythmia.
- Chest injury: Pleurisy has resulted from a chest infection.
- Sickle cell anemia: Pleurisy may cause by sickle cell anemia. Their common symptoms are fatigue and breathing difficulties.
- Pneumothorax: It is often a collapsed lung. Pleurisy has been caused by pneumothorax. The symptoms of pneumothorax are fatigue, rapid heartbeat, breathing difficulty, dry cough, and chest pain.
- Pleural tumor: It is a cancer type that spreads to the pleura in the lungs. The symptoms of pleural tumor are fever, wheezing, cough, chest pain, and breathing difficulties.
Diagnosis
The diagnosis of pleurisy has been initiated with the patient’s medical history and disease symptoms. Check the doctor immediately if a person feels severe chest pain while breathing. The specialist recommends different diagnostic tests to check the severity of pleurisy, which may include:
- Pleural biopsy: In this procedure, a biopsy needle is used to take a small sample of pleura. It has been done to determine cancer, tuberculosis, or other conditions.
- Blood test: Blood tests have been done to evaluate the symptoms of infection and autoimmune disorders like rheumatoid arthritis or lupus.
- Electrocardiogram (ECG): It has been used to check electrical activity and heart rhythm. Small electrodes have been attached to the chest at different points to examine the heart problems.
- Physical exam: A healthcare provider uses a stethoscope to detect the patient’s lungs. It might be pleurisy if he hears the rubbing sound in the lungs.
- CT scan: It has been used to visualize the heart problems, inflammation, tumors, and fluid in the pleural space and create images. The detailed pictures may show the pleural condition.
- Other imaging tests: Other imaging tests, like ultrasounds, MRI scans, and chest X-rays, have been used to check the problems inside the pleural space. For example, blood clot, gas, air, or rib injury.
- Thoracentesis: A doctor removes the air, blood, or fluid surrounding the lungs by inserting a small needle in the pleural space.
- Thoracoscopy: It has been used for the diagnosis of tuberculosis pleurisy. Doctors evaluate the chest activity using a thin tube (thoracoscope).
Treatment of pleurisy
The treatment depends upon the severity of pleurisy. Sometimes, it is a mild pain and can be cured without medicines. For example, viral pleurisy has been fixed without treatment. These are the treatment options for pleurisy, which may include:
- Medications: The doctor has been prescribed an antifungal, antiparasitic, or antibiotic for treating the infection. Doctors suggest ibuprofen relieve pleuritic pain. Corticosteroids have been used to reduce inflammation. Codeine cough syrup has been named to relieve the cough. Furthermore, bronchodilators have been used to ease breathing.
- Chemotherapy or radiation therapy: Sometimes, doctors use chemotherapy or radiation therapy to lessen the tumors that may cause pleurisy.
Complications of pleurisy
These are the potential complications of pleurisy are as follow:
- Pleural effusion (build-up of too many fluids into the pleural space)
- Hemothorax (build-up of blood inside the pleural space)
- Severe illness
- Empyema (pus in the pleural cavity)
- Atelectasis (collapsed in the lungs)
References
https://my.clevelandclinic.org/health/diseases/21172-pleurisy
https://www.webmd.com/lung/understanding-pleurisy-basics
https://www.mayoclinic.org/diseases-conditions/pleurisy/symptoms-causes/syc-20351863#
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pleurisy
https://www.medicalnewstoday.com/articles/158813