Pleurisy

About

Pleurisy is a medical condition that involves inflammation of the pleura, the membrane that surrounds the lungs and lines the chest wall. It usually occurs when fluid gathers in the space between the layers of the membrane, causing pain when the person inhales and exhales. The symptoms of pleurisy include chest pain, shortness of breath, and a dry cough. The most common cause of pleurisy is an infection, such as a virus or bacteria, but it can also occur due to other conditions, such as a pulmonary embolism. Treatment for pleurisy often involves rest and pain relief medications, as well as antibiotics if the pleurisy is caused by a bacterial infection. In some cases, pleurisy may require further treatment, such as draining the fluid from the pleural space or using corticosteroids.

Symptoms

The main symptom of pleurisy is a sharp chest pain that worsens with deep breaths. Other symptoms can include difficulty breathing, a dry cough, fever, and chest tightness. Additional symptoms may include pain in the shoulders and back, abdominal pain, shortness of breath, and a feeling of pressure in the chest.

Causes

The most common causes of pleurisy are viral or bacterial infections. Examples of these are influenza, legionnaires’ disease, or pneumonia. Other causes of pleurisy include autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, or scleroderma; chest trauma or injury; certain medications; chronic obstructive pulmonary disease (COPD); pulmonary embolism; and cancer that has spread to the pleura.

Risk factors

The risk factors for Pleurisy include:

Infection – Viral infections, such as the flu, and bacterial infections, such as pneumonia, are the most common causes of pleurisy.
Autoimmune Disorders – Autoimmune disorders, such as lupus, rheumatoid arthritis, and other Collagen Vascular Diseases, can cause inflammation in the pleura and lead to pleurisy.
Chest Trauma – Traumatic injuries to the chest can cause muscle spasms and inflammation in the pleura resulting in pleurisy.
Lung Disease – Lung diseases, such as pulmonary embolism (PE), chronic obstructive pulmonary disease (COPD), and interstitial lung disease, can lead to pleurisy.
Cancer – Cancer in the pleura, or pleural cancer, can lead to pleurisy.
Medications – Long-term use of certain medications, such as methotrexate, can cause pleurisy.

Diagnosis

Pleurisy is usually diagnosed with a combination of a physical exam, medical history, imaging tests, and laboratory tests. During the physical exam, the doctor will listen to your lungs with a stethoscope and may detect a crackling sound indicating pleurisy. Your doctor may also look for any tenderness or pain when they press on your ribs or back. Imaging tests, such as an X-ray, computed tomography (CT) scan, or ultrasound can help to identify any signs of pleurisy. If there is an infection causing pleurisy, laboratory tests such as a blood test or sputum culture can also be used to accurately diagnose the cause.

Sub-types

Pleurisy is an inflammation of the tissue surrounding the lungs, known as the pleura which typically causes pain in the chest or shoulders when breathing or coughing. There are three main subtypes of pleurisy:

Viral Pleurisy: This form of pleurisy is usually caused by a viral infection, such as the flu (influenza), the common cold, or other illnesses, such as HIV or Tuberculosis. Symptoms typically include mild chest pain and shortness of breath.
Bacterial Pleurisy: This type of pleurisy is caused by a bacterial infection in the pleura and is typically more serious than other forms. It can lead to chest pain, difficulty breathing, fever, and cough.
Chylothorax Pleurisy: This uncommon type of pleurisy is caused by an accumulation of fatty lymph (called chyle) in the pleural cavity due to an obstruction of the thoracic lymphatic system. Symptoms may include severe chest pain and difficulty breathing. Treatment typically requires surgical intervention.

Treatments

Treatment options for pleurisy will typically depend on the underlying cause for the condition. Common treatment options may include:

Pain medications such as ibuprofen or acetaminophen to help reduce inflammation and ease discomfort.
Steroid medications to help reduce swelling.
Antibiotics or antiviral medications to target the underlying infection.
Oxygen to help improve breathing.
Chest physiotherapy to help with drainage of mucus and reduce inflammation.
Surgery if the pleurisy is caused by a more serious condition such as a tumor.
Corticosteroid injections to reduce inflammation.

Prevention

Pleurisy can be prevented by avoiding activities that increase the risk of contact with infectious organisms, such as avoiding close contact with anyone who is ill or has recently been ill, washing hands regularly, avoiding smoking and secondhand smoke, and keeping up to date with recommended vaccinations. Additionally, working to maintain a healthy lifestyle, such as eating a balanced diet, maintaining a healthy body weight, managing stress, and getting regular physical activity can help reduce the risk of developing pleurisy and other illness. Taking steps to reduce air pollution and other environmental toxins can also help reduce the risk. Additionally, seeking prompt medical attention for any symptoms of pleurisy is important in order to begin effective treatment as soon as possible.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Pleurisy. Women are more likely to experience chest wall pain and breathlessness than men, while men are more likely to experience the sharp pain that is a common symptom of pleurisy. Women are also more likely to experience pleurisy during pregnancy, which can make the condition more difficult to diagnose. Additionally, women are more likely to be hospitalized with pleurisy, while men are more likely to be managed with outpatient treatment. Finally, pleurisy is more likely to recur in women than in men, suggesting they may require more intensive management.

Nutrition

Nutrition plays an important role in the management of pleurisy. Eating a healthy, well-balanced diet helps the body to heal and recover from pleurisy. Getting adequate amounts of vitamins and minerals in the diet can help boost the immune system and reduce inflammation. Eating foods that are high in antioxidants, like dark leafy greens, citrus fruits, and berries, may help fight infection and reduce pain. Additionally, limiting sugar, refined carbohydrates, and processed foods is important, as these can increase inflammation. Eating a diet that is full of fiber-rich foods like fruits, vegetables, whole grains, and legumes can help improve the body’s ability to heal itself. Staying hydrated is also important in pleurisy management, as it helps thin mucus and reduce inflammation. Lastly, it is important to note that every person is different and individual needs may vary, so it is important to speak to your doctor to determine the best course of action.

Physical Activity

Physical activity can affect pleurisy in both a positive and negative way depending on the severity of the condition. Light activities, such as walking, stretching, and light jogging, can help reduce pain from pleurisy and reduce inflammation. However, physical activities that involve deep breathing, such as high-intensity exercise, should be avoided, as they can cause further irritation or pressure on the affected area, making the discomfort worse. In addition, activities that put pressure on the chest cavity should also be avoided, as this can cause the pleurisy to worsen.