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Pleurisy

(Pleuritis)

Definition

Pleurisy is an inflammation of the pleura, the double-layered membrane that surrounds each lung and the rib cage. The pleura protects and lubricates the surface of the lungs as they inflate and deflate within the rib cage. When they become inflamed, the diseased surfaces rub painfully together.
Pleura of the Lungs
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Causes

There are several causes for either acute or chronic pleurisy.

Risk Factors

Factors that increase your chance of pleurisy include:

Symptoms

Symptoms of pleurisy include:

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The pain associated with pleurisy can be enough to diagnose the condition. A stethoscope will be used to listen for abnormal chest sounds, such as a friction rub or pneumonia sounds. The next step is determining the illness that caused the pleurisy.
Images may be taken of your bodily structures. This can be done with:
Your bodily fluids may be tested. This can be done with:
Your heart's activity may be tested. This can be done with an EKG.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Pain Management

Pain relievers, such as acetaminophen and anti-inflammatories, are used to treat the pain. Anti-inflammatories may also relieve symptoms related to inflammation. Some people can reduce their pain by lying on the painful side, holding a pillow tightly, or wrapping the chest with elastic bandages. Codeine-based cough syrup may be prescribed to treat a painful cough if it is safe to do so.

Treating the Source of Pleurisy

If pleurisy is the result of a bacterial infection, antibiotics may be prescribed. If it is the result of a viral infection, the virus will get better naturally. If the cause is due to an autoimmune disease such as SLE, then steroid treatment will relieve pain. Pulmonary embolism or pneumothorax may be treated by surgery.

Prevention

To help reduce your chances of getting pleurisy, take the following steps:

RESOURCES

American Lung Association http://www.lung.org

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

The Lung Association http://www.lung.ca

References

Kass SM, Reamy BV. Pleurisy. Am Fam Physician. 2007;75(9):1357-1364.

Pleural effusion. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/pulmonary-disorders/mediastinal-and-pleural-disorders/pleural-effusion. Updated February 2008. Accessed May 29, 2013.

Pleurisy. Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Health-Conditions/Pleurisy.aspx. Accessed May 29, 2013.

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