Pleurisy

Medically reviewed by Drugs.com. Last updated on Oct 6, 2024.

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What is pleurisy?

Pleurisy happens when the pleura becomes irritated or swollen. The pleura is a thin piece of tissue made of 2 layers. One layer lines the inside of your chest cavity, and the other surrounds your lungs. There is a small amount of fluid between the layers that helps them move easily when you breathe. When the pleura is irritated or swollen, the layers rub together as you breathe.

What causes pleurisy?

The cause of pleurisy is not always known. The following may cause pleurisy:

• A viral infection, such as the flu
• A bacterial infection, such as pneumonia or tuberculosis (TB)
• An autoimmune disease, such as rheumatoid arthritis or lupus
• A lung collapse or pulmonary embolism (PE)
• Certain medicines
• Trauma to the chest wall
• Inflammation of the heart
• Lung cancer

What are the signs and symptoms of pleurisy?

• Sharp, stabbing pain in your side or lower part of your chest
• Chest pain that gets worse when you cough, sneeze, or take a breath in
• Shortness of breath
• Pain when your rib area is touched
• Fever or cough
• Fatigue

How is pleurisy diagnosed?

Your healthcare provider will ask about your signs and symptoms. Tell him or her if you have traveled recently or been around anyone who is sick. Your healthcare provider will listen to your lungs as you breathe. You may also need any of the following:

• X-ray, ultrasound, or CT pictures may be used to look for swelling or extra fluid in and around your lungs or between the pleura. You may be given contrast liquid to help your healthcare providers see the pictures better. Tell the healthcare provider if you have had an allergic reaction to contrast liquid.
• Blood tests may show if there is an infection.
• A sample of your sputum may be taken to test for an infection.
• Pleural biopsy may be needed to rule out other conditions.

How is pleurisy treated?

Treatment depends on the cause of your pleurisy and how severe your symptoms are. Your healthcare provider will treat the cause of your pleurisy. You may need any of the following:

• Cough medicine helps decrease your urge to cough. A cough suppressant may help if a dry cough is causing your pain.
• Antibiotics may treat pleurisy caused by bacteria.
• Steroids may be given to decrease inflammation.
• Prescription pain medicine may be given if other pain medicines do not work. Do not wait until the pain is severe before you ask for more medicine.
• You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• doxycycline
• Vibramycin
• Doryx
• Monodox
• Doxy 100

How can I manage my symptoms?

• Find a comfortable position. You will need to rest to let your body heal. Find a position that allows you to decrease pain and breathe easier. You may find it comfortable to lie on the side that has the pleurisy. Change your position often to prevent complications, such as worsening pneumonia or a lung collapse.
• Use pressure to prevent pain. Hold a pillow against your chest when you cough or take a deep breath.

How can I prevent pleurisy?

• Get early treatment for conditions that cause pleurisy.
• Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
• Ask about vaccines. Ask your healthcare provider if you should get a flu or pneumonia vaccine. These vaccines may prevent infections that cause pleurisy. The flu vaccine is given every year. The pneumonia vaccine is usually given every 5 years.

Call your local emergency number (911 in the US) if:

• You have sudden, intense chest pain that feels different from your symptoms.
• You are breathing fast, feel confused, or feel like you are going to faint.

When should I seek immediate care?

• You cough up blood.
• You feel more short of breath than usual.
• Your lips or fingernails turn dusky or blue.

When should I call my doctor?

• Your pain gets worse, even after treatment.
• You have a fever.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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