What is pleurisy?
Pleurisy (also termed pleuritis) is inflammation of the double layered membrane that surrounds the lungs termed the pleura or plural membranes. These membranes surround the lungs (visceral pleura) and line the ribcage (parietal pleura).
The pleura lubricate the lungs, and this allows the lung tissue to easily inflate and deflate as a person breathes in and out. In between the plural membranes is a very thin area containing fluid that allows easy non-painful movement of the lung tissue. When pleurisy occurs, several things may happen. If inflammation occurs, the two layers of the membrane can become rough and as they attempt to slide, the rough surfaces cause pain. In other instances, fluid can begin to build up between the membranes and put pressure on the lungs that, in turn, reduces the lungs' ability to move normally and can cause shortness of breath. This situation is turned a "plural effusion." In some people, this pleural effusion can become infected, and inflammation of the pleura can occur.
Some doctors believe that pleurisy is a symptom of an underlying condition and is not a condition itself. Classification of pleurisy can be acute, subacute, chronic and/or recurrent, depending upon the underlying condition causing pleurisy. In this article, pleurisy will be considered a term for a generalized condition that results in chest discomfort.
Is pleurisy contagious?
Most doctors agree that pleurisy is not contagious in itself; however, some of the underlying conditions that may cause pleurisy are considered contagious (for example, tuberculosis, bacterial pneumonia and viral infections like influenza [the flu]).
Other diseases that can be the underlying cause of pleurisy are not contagious (for example, heart attack, pulmonary embolism, certain cancers, rheumatoid arthritis, lupus and many others; sometimes the underlying cause of pleurisy is not known).
How will I know if I have pleurisy?
Although the underlying causes of pleurisy may have a large number of symptoms, a common feature in patients with pleurisy is having a "plural rub," a situation in which the two membranes (parietal and visceral pleura) move together to cause friction and pain that is usually sharp. The pain is usually localized to the area that is inflamed and is increased when the patient coughs, sneezes or tries to take a deep breath. During the physical exam, a doctor may hear reduced breath sounds, wheezing and/or rapid shallow breathing.
Such findings usually cause the health-care professional to order tests like a chest X-ray, CT of the chest, and/or other tests, depending upon the health-care professional's suspicion of an underlying cause of pleurisy. Often, an EKG and blood tests are done to determine whether a medical emergency such as a heart attack has occurred. Consequently, it is important to have a health-care professional quickly diagnose a person that develops the common symptoms of pleurisy.
How is pleurisy spread?
Pleurisy is not spread from person to person; however, it may spread within the individual to occupy more space. This occurs when the underlying infectious causes further spread into the pleural space or when noninfectious causes result in fluid increases in the pleural space. In some people, both infection and fluid can increase (spread) simultaneously in the pleural space.
How will I know if I am cured of pleurisy?
Treatment for pleurisy depends on the underlying cause. It is possible to be cured of pleurisy if the underlying cause is treatable. For example, if the underlying cause like bacterial infection is stopped and cured, the symptoms described above that occur with pleurisy will resolve (abate) over time. The time span is dependent upon the time it takes to cure of the underlying cause of the disease. This situation is the same for the non-infectious causes of pleurisy.
Occasionally, a pleural effusion will not clear up even if the underlying cause of pleurisy has been effectively treated, and in other patients, the pleural effusion may compromise breathing. In these situations, a chest tube is placed into the effusion so it can be drained; after effective drainage, most patients' symptoms resolve, and the tube is removed.
When should I contact a doctor about pleurisy?
Because pleurisy, especially in the acute form, involves chest pain, is important to be sure that the pain is not due to a medical emergency. Consequently, acute pleuritic pain should be evaluated immediately by an emergency physician to help differentiate between a heart attack or other emergency conditions and new-onset pleurisy. However, other forms of pleurisy (for example, chronic or recurrent) still need to be evaluated quickly by the patient's doctor or specialist to avoid hospitalization and/or complications that could lead to poor outcomes.
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National Health Services, UK. "Pleurisy Treatment." Reviewed 01/28/15.