Pleuritis (inflammation of the lungs cover)

Chest | Pulmonology | Pleuritis (inflammation of the lungs cover) (Disease)


The pleura is a two layered sac that holds the lungs and separates them from thechest wall, diaphragm, and heart. Pleurisy results from an inflammation of this sac.

The pleura that lines the inside of the chest is called the parietal pleura. The pleura that covers the lungs is called the visceral pleura. If you are healthy, the pleurais separated by a thin layer of fluid. This lets the lungs expand and contract easily during breathing.

The inflammation that occurs with pleurisy can cause pain with breathing and may even cause a large amount of fluid to collect in the pleural sac. Pleurisy can go away on its own or worsen so that fluid has to be drained from around the lungs. Some people develop scar tissue called adhesions after they have pleurisy. They then have chronic pain or shortness of breath.

The main symptom of pleurisy is a sharp or stabbing pain in the chest that gets worse with deep breathing, coughing, sneezing or laughing. The pain may stay in one place, or it may spread to the shoulder or back. Sometimes it becomes a fairly constant dull ache.

Causes and Risk factors

Viral infection is the most common cause of pleurisy. However, many different conditions can cause pleurisy: pneumothorax, bacterial infections like pneumonia and tuberculosis, autoimmune disorders like systemic lupus erythematosus (or drug-induced lupus erythematosus) and rheumatoid arthritis, lung cancer and lymphoma, pulmonary embolism, a blood clot in the blood vessels that go into the lungs, inflammatory bowel disease, familial Mediterranean fever, an inherited condition that often causes fever and swelling in the abdomen or lung, infection from a fungus or parasite and heart surgery, especially coronary artery bypass grafting.

Some cases of pleurisy are idiopathic, meaning the cause cannot be determined.

Diagnosis and Treatment

Treatment depends on what is causing the pleurisy and may include: nonsteroidal anti-inflammatory medications (ibuprofen, naproxen), pain medications such as acetaminophen, antibiotics, autoimmune medications, and/or chemotherapy.


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