Pleurisy

Pleurisy is the swelling in the pleurae of your lungs. Your pleurae are the 2-ply layer of tissue (membrane) that goes all around each of your lungs and also covers the inside of your chest cavity. You have 2 pleurae around each lung.

Your pleurae act as a protective covering that fits snugly around your lung. Usually, there is no real space between the inner and outer layers. The pleurae are joined together at the edges. There is a thin layer of fluid between the 2 layers that helps lubricate. This helps you breathe easily. If the fluid in the pleural space increases it can cause a pleural cavity to form.

Causes:

Pleurisy may be:

1. wet pleurisy (too much fluid in the pleural cavity)
2. dry pleurisy.

2 kinds of pleurisy:

• "Primary pleurisy". This is swelling in the pleural tissue that may be caused by germs, injury, or a tumor.
• "Secondary pleurisy". Caused by something else happening in the chest like pneumonia, tuberculosis, or lung abscess.

The symptoms of both these types may be exactly the same.

• Every time you breathe you may feel stabbing, knifelike pain in your chest.
• The pain may be really bad when you cough or sneeze or take a deep breath.
• Your pain may be there day or night.
• You will want to breathe shallow and may have a hard time to breathe.
• Dry cough
• Weakness
• Headache
• You may lose your appetite.
• Chills, fever
• Fast pulse

Problems that pleurisy may cause:

Dry pleurisy: It can cause adhesions (pieces of tissue left behind) that are attached to your lung and your chest wall. Sometimes, there can be so many adhesions that it keeps your lungs from moving the way they should. Usually the adhesions stretch and the pain goes away.

Wet pleurisy: The fluid builds up in your pleural cavity. Sometimes there is so much fluid there that it keeps the lungs from moving like they should and you have a hard time to breathe. More fluid may also cause the linings to come apart which limits the movement of your chest wall and the outer lining. This may actually cause a decrease in pain.

• If there is a large amount of fluid it can cause your heart to be pushed over as well as your lung(s). The pleura may not go back to its original size after the fluid is absorbed, which may interfere with your lung(s) working properly.
• Clear fluid may not be much of a problem and be quite easily absorbed. The fluid can get infected and turn to pus causing empyema. This is very serious. Sometimes the pus goes through your lung wall into the air spaces. The pus may be coughed up. Usually the pus will need to be removed.

Treatment:

• You need to get treatment for what caused the pleurisy.
• To help decrease your pain, you may want to lie on your sore side on a firm surface to help limit the amount of movement of your lungs.
• Medication for pain
• For wet pleurisy, the doctor may suggest to have the fluid removed by a needle. When this is done is very important because if it is taken out too soon the fluid may come back. If it is not taken out soon enough large adhesions may form and cause you permanent trouble with your breathing.
• Rest

Return to the Emergency Department or see your doctor very soon IF:

• Your symptoms get worse.
• Your pain feels different.
• You feel shorter of breath.